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.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33011 |
| Date | January 2001 |
| Creators | Klein, Marina B. |
| Contributors | Suissa, Samy (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001838273, proquestno: MQ75325, Theses scanned by UMI/ProQuest. |
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