摘要
Persons chronically infected with hepatitisCvirus (HCV), some of whom may be coinfected with HIV and human T-lymphotropic virus type II (HTLV-II), are at high risk for end-stage liver disease (ESLD). We evaluated whether ESLD death was associated with premorbid HCV RNA level or specific HCV protein antibodies among persons with or without HIV/HTLVII coinfection in a cohort of 6,570 injection drug users who enrolled in 9 US cities between 1987 and 1991. We compared 84 ESLD descendents and 305 randomly selected cohort participants with detectable HCV RNA, stratified by sex, race, HIV, and HTLV-II strata. Relative hazard (RH) of ESLD death was derived from the proportional hazard model. Risk of ESLD death was unrelated to the intensity of antibodies against the HCV c- 22(p), c- 33(p), c- 100(p), and NS5 proteins, individually or combined, but it increased with HCV RNA level (RHadj = 2.26 per log10 IU/mL, 95% CI: 1.45- 5.92). The association between HCV RNA level and ESLD death remained significant after adjustment for alcohol consumption (RHadj = 2.57 per log10 IU/mL, 95% CI: 1.50- 8.10). Deaths from AIDS (n = 45) and other causes (n = 43) were unrelated to HCV RNA (RHadj = 1.14 and 1.29 per log10 IU/mL, respectively). HIV infection was not associated with ESLD risk in multivariate analyses adjusted for HCV RNA. Men had an increased risk of ESLD death in unadjusted analyses (RH = 1.92, 95% CI: 1.15- 3.56) but not in multivariate analysis (RHadj = 0.98, 95% CI: 0.48- 2.88). Non-black patients were at increased risk for ESLD death (RHadj = 2.76, 95% CI: 1.49- 10.09). In conclusion, HCV RNA level is a predictor of ESLD death among persons with chronic HCV infection.
Persons chronically infected with hepatitisCvirus （HCV）, some of whom may be coinfected with HIV and human T-lymphotropic virus type Ⅱ （HTLV-Ⅱ）, are at high risk for end-stage liver disease （ESLD）. We evaluated whether ESLD death was associated with premorbid HCV RNA level or specific HCV protein antibodies among persons with or without HIV/HTLVII coinfection in a cohort of 6, 570 injection drug users who enrolled in 9 US cities between 1987 and 1991. We compared 84 ESLD descendents and 305 randomly selected cohort participants with detectable HCV RNA, stratified by sex, race, HIV, and HTLV-Ⅱ strata. Relative hazard （RH） of ESLD death was derived from the proportional hazard model. Risk of ESLD death was unrelated to the intensity of antibodies against the HCV c - 22 （p）, c-33（p）, c-100（p）, and NS5 proteins, individually or combined, but it increased with HCV RNA level （RHadj = 2. 26 per log10 IU/mL, 95% CI： 1.45 -5. 92） .The association between HCV RNA level and ESLD death remained significant after adjustment for alcohol consumption （RHadj = 2.57 per log10 IU/mL, 95% CI： 1.50- 8.10） . Deaths from AIDS （n = 45） and other causes （n = 43） were unrelated to HCV RNA （RHadj = 1.14 and 1.29 per log10 IU/mL, respectively） . HIV infection was not associated with ESLD risk in multivariate analyses adjusted for HCV RNA. Men had an increased risk of ESLD death in unadjusted analyses （RH = 1.92, 95% CI： 1.15 - 3.56） but not in multivariate analysis （RHadj = 0.98, 95% CI： 0.48-2.88）.
