HIV coinfection with hepatitis c natural history, complications and prognosis

The effect of HCV on the natural history of HIV remains inconclusive due to contradictory studies documenting no effect, while others show an increase to an AIDS defining illness or death. The morbidity and mortality caused by HCV has increased since the inception of highly active antiretroviral therapy (HAART) because HIV patients are living longer from potent antiretroviral therapies and prophylaxis of traditional opportunistic infections. Infection with HCV can be asymptomatic, self-limiting, or progress to cirrhosis or cancer.

Over years or decades chronic hepatitis B and C can progress to serious liver disease including cirrhosis and liver cancer. HIV positive people with HBV or HCV tend to experience more rapid disease progression and do not respond as well to hepatitis treatment. End-stage liver disease is now the cause of death for 45% of HIV-infected patients in this hospital. HCV infection was the cause of the liver disease in nearly three-quarters of the HIV patients who were admitted or died during the course of the study.^[1]