Lack of association of hepatitis C virus load and genotype with risk of end-stage liver disease in patients with human immunodeficiency virus coinfection

In hepatitis C virus (HCV) infection, virus load and the risk for HCV-relat ed end-stage liver disease (ESLD) are increased among persons with human im munodeficiency virus (HIV) coinfection. To clarify these relationships, 42 hemophilic patients who developed ESLD and random samples from 164 hemophil ic patients with HCV infection alone and 146 with HCV-HIV coinfection were tested for HCV load and genotype. HCV genotype was unrelated to HIV and age . In contrast, HCV load was higher with older age (P-trend = .0001) and wit h HIV coinfection (6.2 vs. 5.9 log(10) genome equivalents/mL, P = .0001). D uring 16 years of follow- up of dually infected patients, ESLD risk was unr elated to HCV load overall (P-trend = .64) or separately to HCV genotype 1 and genotypes 2 or 3 (P-trend greater than or equal to .70). Irrespective o f virus load, incidence of ESLD was marginally increased 2-fold (95% confid ence interval, 0.8-5.6) with HCV genotype 1. Understanding the discordance between HCV load and ESLD, despite HIV's link to each of these, may help cl arify the pathogenesis of HCV-related disease.