Systematic review and meta-analysis of hepatitis C virus infection and HIV viral load: New insights into epidemiologic synergy

• Type of Material: Article
• Authors: Patrick S Sullivan, Emory University; Nicholas Petersdorf, University of London; Jennifer M. Ross, University of Washington, Seattle; Helen A. Weiss, University of London; Ruanne V. Barnabas, University of Washington, Seattle; Judith N. Wasserheit, University of Washington, Seattle
• Language: English
• Date: 2016-01-01
• Publisher: Wiley Open Access
• Publication Version: Final Published Version
• Copyright Statement: © 2016 Jao J et al; licensee International AIDS Society.
• License: Creative Commons Attribution 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.7448/IAS.19.1.20944
• Title of Journal or Parent Work: Journal of the International AIDS Society
• ISSN: 1758-2652
• Volume: 19
• Issue: 1
• Start Page: 20944
• End Page: 20944
• Grant/Funding Information: JR acknowledges funding support from NIH/NIAID (T32AI007140).; HW acknowledges MRC funding through grant MR/K012126/1. Research reported in this publication was also supported by the NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS and NIDDK of the National Institutes of Health under award number AI027757 to RB.
• Keywords: Antiviral Agents; Hepacivirus; hepatitis C virus; systematic review; Hepatitis C; HIV; HCV; HIV Infections; Humans; viral load; Coinfection; Viral Load; co-infection
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Immunology

Abstract

Introduction: Hepatitis C virus (HCV) and HIV infection frequently co-occur due to shared transmission routes. Co-infection is associated with higher HCV viral load (VL), but less is known about the effect of HCV infection on HIV VL and risk of onward transmission. Methods: We undertook a systematic review comparing 1) HIV VL among ART-naýve, HCV co-infected individuals versus HIV mono-infected individuals and 2) HIV VL among treated versus untreated HCV co-infected individuals. We performed a randomeffects meta-analysis and quantified heterogeneity using the I 2 statistic. We followed Cochrane Collaboration guidelines in conducting our review and PRISMA guidelines in reporting results. Results and discussion: We screened 3925 articles and identified 17 relevant publications. A meta-analysis found no evidence of increased HIV VL associated with HCV co-infection or between HIV VL and HCV treatment with pegylated interferon-alpha-2a/b and ribavirin. Conclusions: This finding is in contrast to the substantial increases in HIV VL observed with several other systemic infections. It presents opportunities to elucidate the biological pathways that underpin epidemiological synergy in HIV co-infections and may enable prediction of which co-infections are most important to epidemic control.