Hepatitis C virus is related to progressive liver disease in human immunodeficiency virus-positive hemophiliacs and should be treated as an opportunistic infection

The hypothesis was investigated that hepatitis C virus (HCV) infection beha ves like an opportunistic infection in which progressive liver disease (PLD ) is the principal manifestation. PLD in 81 hemophiliacs coinfected with HC V and human immunodeficiency virus (HIV) was compared with 53 HIV-seronegat ive HCV-infected hemophiliacs. Progression to AIDS and death in 22 HCV/HIV- coinfected hemophiliacs with PLD was also compared with 59 coinfected hemop hiliacs who did not develop PLD, The risk of PLD occurrence associated with an HIV-positive status was 7.4 (95% confidence interval [CI], 2.2-25.5; Co x model). In the coinfected group, the risk of PLD occurrence was higher in subjects with severe AIDS-defining immunodeficiency than in those without (odds ratio, 3.6; 95% CI, 1.3-10), Persons with PLD also had a faster progr ession to AIDS (P = .03, log rank test) than those without PLD, Thus, as wi th other chronic resident human viruses, HCV should be considered another o pportunistic pathogen in HIV disease.