Influence of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis

Studies have shown that rates of liver disease are higher in persons who ar e coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) than they are in persons with HCV alone, but estimates of risk vary w idely and are based on data for dissimilar patient populations. We performe d a meta-analysis to quantify the effect of HIV coinfection on progressive liver disease in persons with HCV. Eight studies were identified that inclu ded outcomes of histological cirrhosis or decompensated liver disease. Thes e studies yielded a combined adjusted relative risk (RR) of 2.92 (95% confi dence interval [CI], 1.70-5.01). Of note, studies that examined decompensat ed liver disease had a combined RR of 6.14 (95% CI, 2.86-13.20), whereas st udies that examined histological cirrhosis had a pooled RR of 2.07 (95% CI, 1.40-3.07). There is a significantly elevated RR of severe liver disease i n persons who are coinfected with HIV and HCV. This has important implicati ons for timely diagnosis and consideration of treatment in coinfected perso ns.