Brief Articles
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World J Gastroenterol. Feb 28, 2009; 15(8): 996-1003
Published online Feb 28, 2009. doi: 10.3748/wjg.15.996
Impact of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis
Li-Ping Deng, Xi-En Gui, Yong-Xi Zhang, Shi-Cheng Gao, Rong-Rong Yang
Li-Ping Deng, Xi-En Gui, Yong-Xi Zhang, Shi-Cheng Gao, Rong-Rong Yang, Department of Infectious Diseases, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China
Author contributions: Deng LP, Gui XE, Zhang YX, Gao SC and Yang RR designed the research; Deng LP, Gui XE and Zhang YX performed the research; Deng LP, Gao SC and Yang RR analyzed the data; Deng LP and Gui XE wrote the paper.
Correspondence to: Xi-En Gui, Professor, Department of Infectious Diseases, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China. znact@126.com
Telephone: +86-27-67812880
Received: October 19, 2008
Revised: February 8, 2009
Accepted: February 1, 2009
Published online: February 28, 2009
Abstract

AIM: To analyze the influence of human immunode-ficiency virus (HIV) infection on the course of hepatitis C virus (HCV) infection.

METHODS: We performed a meta-analysis to quantify the effect of HIV co-infection on progressive liver disease in patients with HCV infection. Published studies in the English or Chinese-language medical literature involving cohorts of HIV-negative and -positive patients coinfected with HCV were obtained by searching the PUBMED, EMBASE and CBM. Data were extracted independently from relevant studies by 2 investigators and used in a fixed-effect meta analysis to determine the difference in the course of HCV infection in the 2 groups.

RESULTS: Twenty-nine trails involving 16 750 patients were identified including the outcome of histological fibrosis or cirrhosis or de-compensated liver disease or hepatocellular carcinoma or death. These studies yielded a combined adjusted odds ratio (OR) of 3.40 [95% confidence interval (CI) = 2.45 and 4.73]. Of note, studies that examined histological fibrosis/cirrhosis, decompensated liver disease, hepatocellular carcinoma or death had a pooled OR of 1.47 (95% CI = 1.27 and 1.70), 5.45 (95% CI = 2.54 and 11.71), 0.76 (95% CI = 0.50 and 1.14), and 3.60 (95% CI = 3.12 and 4.15), respectively.

CONCLUSION: Without highly active antiretroviral therapies (HAART), HIV accelerates HCV disease progression, including death, histological fibrosis/cirrhosis and decompensated liver disease. However, the rate of hepatocellular carcinoma is similar in persons who had HCV infection and were positive for HIV or negative for HIV.

Keywords: Human immunodeficiency virus; Hepatitis C virus; Coinfection; Disease progression; Meta-analysis