Liver-related death among HIV/hepatitis C virus-co-infected individuals: implications for the era of directly acting antivirals. AIDS
Grint et al. on behalf of EuroSIDA aimed to describe causes of death among HIV/HCV-co-infected individuals to identify factors associated with liver-related death (LRD) and to provide guidance on who should be prioritized for treatment of HCV infection with directly acting antivirals (DAAs). One hundred forty-five out of 670 deaths (21.6%) were classified as liver-related, equating to an overall incidence of LRD of 9.0. LRD rates were 35-fold higher among those with F4 fibrosis compared with those having F0/F1 fibrosis, and 8-fold higher than those with F2/F3 fibrosis. Factors associated with LRD were HBsAg-positivity, CD4+ cell count per doubling, and age between 35 and 45 years.
In conclusion, those with significant liver fibrosis (≥F2) should be prioritized for treatment with DAAs and early initiation of cART should be considered essential to decrease the risk of LRD.