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Chronic hepatitis C virus infection and subsequent HIV viral load among women with HIV initiating antiretroviral therapy

机译：慢性丙型肝炎病毒感染和随后艾滋病毒启动抗逆转录病毒治疗妇女的艾滋病毒病毒载量

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Objectives:One in four persons living with HIV is coinfected with hepatitis C virus (HCV). Biological and behavioral mechanisms may increase HIV viral load among coinfected persons. Therefore, we estimated the longitudinal effect of chronic HCV on HIV suppression after ART initiation among women with HIV (WWH).Design:HIV RNA was measured every 6 months among 441 WWH in the Women's Interagency HIV Study who initiated ART from 2000 to 2015.Methods:Log-binomial regression models were used to compare the proportion of study visits with detectable HIV RNA between women with and without chronic HCV. Robust sandwich variance estimators accounted for within-person correlation induced by repeated HIV RNA measurements during follow-up. We controlled for confounding and selection bias (because of loss to follow-up and death) using inverse probability-of-exposure-and-censoring weights.Results:One hundred and fourteen women (25%) had chronic HCV before ART initiation. Overall, the proportion of visits with detectable HIV RNA was similar among women with and without chronic HCV [relative risk (RR) 1.19 (95% CI 0.72, 1.95)]. Six months after ART initiation, the proportion of visits with detectable HIV RNA among women with chronic HCV was 1.88 (95% CI 1.41-2.51) times that among women without HCV, at 2 years, the ratio was 1.60 (95% CI 1.17-2.19), and by 6 years there was no difference (1.03; 95% CI 0.60-1.79).Conclusion:Chronic HCV may negatively impact early HIV viral response to ART. These findings reaffirm the need to test persons with HIV for HCV infection, and increase engagement in HIV care and access to HCV treatment among persons with HIV/HCV coinfection.
机译：目的：用丙肝炎病毒（HCV）携带艾滋病毒的四个人中的一个。生物和行为机制可能会增加辛合人群中的艾滋病毒病毒载量。因此，我们估计慢性HCV对艾滋病毒（WWH）妇女妇女的发起后核心抑制对艾滋病毒抑制的纵向效应方法：使用对数型回归模型进行比较患有慢性HCV的妇女可检测的HIV RNA的研究访问比例。强大的三明治差异估计算用于在随访期间反复艾滋病毒RNA测量诱导的人内相关性。我们控制了混淆和选择偏见（由于随访和死亡的损失）使用逆概率和审查的重量来控制总体而言，在没有慢性HCV的女性中，可检测的HIV RNA的访问比例相似[相对风险（RR）1.19（95％CI 0.72,1.95）]。六个月后，术后六个月，慢性HCV的妇女可检测的HIV RNA的访问比例为1.88（95％CI 1.41-2.51），在2年内，女性没有HCV的次数，比例为1.60（95％CI 1.17- 2.19），6年没有差异（1.03; 95％CI 0.60-1.79）。结论：慢性HCV可能对艺术产生负面影响的早期艾滋病病毒病毒反应。这些调查结果重申需要使用HIV进行HCV感染的人，并增加HIV / HCV繁殖的人中艾滋病毒护理和HCV治疗的参与。

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