Pretreatment Anemia Raises Mortality Risk Among HCV/HIV Coinfected Patients

Researchers investigated the impact of anemia prior to treatment on survival of patients with hepatitis C virus (HCV) and HIV coinfection. During 7 years of follow-up, researchers reviewed data from 5,000 patients with HCV and HIV coinfection, including 1,671 who had anemia before beginning therapy. Data were taken from the Electronically Retrieved Cohort of Hepatitis C-Infected Veterans. The researchers determined mortality rates and compared rate of participants with and without pretreatment anemia and between anemic patients who did and did not have HCV treatment.

Results showed significant associations between pretreatment anemia and certain factors, including advanced age, African-American race, and the presence of chronic kidney disease, decompensated liver disease, and cancer. Among the participants, 333 nonanemic and 84 anemic patients initiated HCV therapy. Anemic patients were less likely than nonanemic patients to undergo therapy. Anemic patients had significantly higher mortality rates (144.2 deaths per 1,000 person-years compared with 47.5 for nonanemic), while anemic patients who had HCV treatment had lower rates than those who did not (66.6 per 1,000 person-years compared with 149.5). Receiving HCV therapy was significantly associated with improved mortality rates.

Researchers concluded the study demonstrated that HCV treatment was associated with greater survival benefit in patients with HCV/HIV coinfection and pretreatment anemia. They stated that further study was needed to find ways to optimize HCV treatment to improve the treatment rates among patients with pretreatment anemia.

The full report, “Hepatitis C Virus Treatment and Survival in Patients with Hepatitis C and Human Immunodeficiency Virus Co-infection and Baseline Anaemia,” was published online in the Journal of Viral Hepatitis (2013;doi:10.1111/jvh.12107).

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