Systematic review and meta‐analysis of hepatitis C virus infection and HIV viral load: new insights into epidemiologic synergy
Nicholas Petersdorfa, Jennifer M. Rossb c✉, Helen Anne Weissd, Ruanne V. Barnabasc e f, Judith N. Wasserheitc e f, for the HCV and HIV Transmission Working Groupa
- aLondon School of Economics, University of London, London, UK
- bDivision of Infectious Diseases, University of Washington, Seattle, WA, USA; jross3@uw.edu
- cDivision of Infectious Diseases, University of Washington, Seattle, WA, USA
- dMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, University of London, London, UK
- eDepartment of Epidemiology, University of Washington, Seattle, WA, USA
- fDepartment of Global Health, University of Washington, Seattle, WA, USA
- ✉Corresponding author
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Abstract
INTRODUCTION: Hepatitis C virus (HCV) and HIV infection frequently co-occur due to shared transmission routes. Co-infection is associated with higher HCV viral load (VL), but less is known about the effect of HCV infection on HIV VL and risk of onward transmission. METHODS: We undertook a systematic review comparing 1) HIV VL among ART-naïve, HCV co-infected individuals versus HIV mono-infected individuals and 2) HIV VL among treated versus untreated HCV co-infected individuals. We performed a random-effects meta-analysis and quantified heterogeneity using the I(2) statistic. We followed Cochrane Collaboration guidelines in conducting our review and PRISMA guidelines in reporting results. RESULTS AND DISCUSSION: We screened 3925 articles and identified 17 relevant publications. A meta-analysis found no evidence of increased HIV VL associated with HCV co-infection or between HIV VL and HCV treatment with pegylated interferon-alpha-2a/b and ribavirin. CONCLUSIONS: This finding is in contrast to the substantial increases in HIV VL observed with several other systemic infections. It presents opportunities to elucidate the biological pathways that underpin epidemiological synergy in HIV co-infections and may enable prediction of which co-infections are most important to epidemic control.
TL;DRHepatitis C virus (HCV) and HIV infection frequently co‐occur due to shared transmission routes and less is known about the effect of HCV infection on HIV VL and risk of onward transmission. (Semantic Scholar)