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Impact of hepatitis C virus coinfection and highly active antiretroviral therapy on human immunodeficiency virus associated morbidity and mortality

The impact of hepatitis C virus (HCV) coinfection on HIV related morbidity and mortality is debated, particularly in the era of highly active antiretroviral therapy (HAART). Using the Montreal Chest Institute HIV clinic database, a retrospective cohort spanning 1990--1999 was formed to determine the effect of HCV status on risk of opportunistic infection, death and hospitalisation before and after the introduction of HAART. While HCV- subjects experienced rate reductions for all outcomes after HAART, no such decrease was observed for HCV+ subjects. No effect of HCV status on outcomes was observed before HAART. In contrast, HCV infection was associated with an increased risk of death (RR, 1.80; 95% CI 0.88--3.65) and hospitalisation (RR, 1.90; 95% CI, 1.19--3.05) in the post HAART era after adjustment for age, duration of HIV infection, history of AIDS, antiretroviral use and time-updated CD4 cell and HIV viral load measures. In conclusion, HCV coinfection appears to be preventing the realisation of substantial health benefits associated with HAART.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33011
Date January 2001
CreatorsKlein, Marina B.
ContributorsSuissa, Samy (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageMaster of Science (Department of Epidemiology and Biostatistics.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001838273, proquestno: MQ75325, Theses scanned by UMI/ProQuest.

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