Survival analysis over a 20-year period of a Brazilian cohort of blood donors coinfected HIV-HCV.

Abstract

Among individuals coinfected with HCV and HIV, studies of mortality from non-hepatic causes have shown inconsistent results. The aim of this study was to investigate the contribution of HCV and HIV co-infection to mortality from hepatic and non-hepatic causes in Brazil. This retrospective cohort study included blood donors from Fundação Pró-Sangue de São Paulo (FPS) who were followed from 1994 to 2016 to compare mortality and its causes between HIV-HCV coinfected individuals versus those seronegative for all tested infections. Records from the FPS database and the Mortality Information System were linked through a probabilistic record Relationship (RL). The Hazard Ratio (HR) was estimated using Cox multiple regression models. HCV-HIV coinfected individuals compared to seronegative individuals had a higher risk of death from all causes (HR=14.54), non-liver neoplasms (HR=2.55), infections (HR=10.37) and liver disease (HR=7.0). In addition, HCV mono-infected individuals compared to seronegative individuals had a higher risk of death from all causes (HR=2.23), liver cancer (HR=32.21), liver disease (HR=14.92), infection (HR=3.22), and trauma (HR=1.68). Individuals coinfected with HCV and HIV have increased overall mortality and death due to infections, liver diseases and non-liver neoplasms as compared to those uninfected with HCV and HIV.