Canadians coinfected with HIV and hepatitis C virus (HCV) had a worse response to antiretroviral therapy (ART) and a higher death rate if they had an injection drug use (IDU) history. The findings could clarify understanding of how HCV affects HIV infection.
CANOC Collaboration investigators observed that worse clinical outcomes seen in HIV/HCV-coinfected people may be partly attributable to socioeconomic and medical factors associated with injection drug use, which is the prime route of HCV transmission in people with HIV.
To assess the impact of injection drug use on HIV outcomes, the CANOC team studied coinfected people starting ART after 1 January 2000. The analysis included only people known to have-or not to have-an IDU history. The researchers used Cox proportional hazards regression to evaluate time from ART initiation to virologic suppression (two consecutive viral loads below 250 copies/mL) and gaining at least 100 CD4 cells/μL. To evaluate time to death, they used a competing risk analysis to account for loss to follow-up (dropping out of care).
Mark Mascolini
International AIDS Society
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