Abstract
Hepatitis C virus (HCV) may increase pulmonary hypertension (PH) risk among people living with HIV (PLWH). Prior studies on this topic have been relatively small and examined selected populations. We determine whether HIV/HCV coinfection is associated with higher pulmonary artery systolic pressure (PASP) and prevalent echocardiographic PH. We performed a cross-sectional analysis of 6032 (16% HIV/HCV coinfected) Veterans Aging Cohort Study participants enrolled 4/1/2003–9/30/2012 with echocardiographic PASP measures. We performed multiple linear and logistic regression analyses to determine whether HIV/HCV mono- or co-infection were associated with PASP and PH compared to uninfected individuals. Individuals with HIV/HCV coinfection displayed a higher PASP than uninfected individuals (widehat{beta }=1.10, 95% CI 0.01, 2.20) but there was no association between HIV/HCV coinfection and prevalent PH. Subset analyses examined HIV and HCV disease severity markers separately and jointly. Among PLWH, HCV coinfection (widehat{beta }=1.47, 95% CI 0.26, 2.67) and CD4 + cell count (widehat{beta }= − 0.68, 95% CI − 1.10, − 0.27), but not HIV viral load nor ART regimen, were associated with PASP. Among people with HCV, neither HIV coinfection nor HCV biomarkers were associated with PASP. Among US veterans referred for echocardiography, HIV/HCV coinfection was not associated with a clinically significant elevation in pulmonary pressure. Lower absolute CD4 + T-cell count was inversely associated with PASP which warrants further investigation in prospective studies.
Highlights
Hepatitis C virus (HCV) may increase pulmonary hypertension (PH) risk among people living with HIV (PLWH)
Small studies in selected populations suggest that the prevalence of PH may be increased among PLWH coinfected with chronic hepatitis C virus (HCV) c oinfection[4,5,6,7]; these observations have yet to be examined in large cohorts
The primary goal of this study is to determine whether HIV/HCV coinfection is associated with echocardiographic PH among US veterans and to identify viral factors associated with higher pulmonary artery systolic pressure (PASP)
Summary
Hepatitis C virus (HCV) may increase pulmonary hypertension (PH) risk among people living with HIV (PLWH). Prior studies on this topic have been relatively small and examined selected populations. We determine whether HIV/HCV coinfection is associated with higher pulmonary artery systolic pressure (PASP) and prevalent echocardiographic PH. The primary goal of this study is to determine whether HIV/HCV coinfection is associated with echocardiographic PH among US veterans and to identify viral factors associated with higher PASP. We hypothesized that HIV/HCV coinfection would be associated with echocardiographic PH and that markers of uncontrolled HIV/ HCV disease activity would be associated with higher echocardiographic estimates of PASP To test these hypotheses, we used data from the Veterans Aging Cohort Study (VACS), an electronic health record-based cohort that contains demographic, clinical, and echocardiographic data on veterans with and without HIV infection[8]. This study builds on our prior work in VACS examining the effects of viral load, CD4 + count, and HCV on P ASP9,10
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