RESEARCH ARTICLE


HIV RNA and HCV RNA Levels, and Mortality: The Japan Cohort Study of HIV Patients Infected through Blood Products



Miyuki Kawado1, *, Makiko Naka Mieno2, Shuji Hashimoto3, Kagehiro Amano4, Miwa Ogane5, Shin-ichi Oka5, Gaku Okamoto6, Hiroyuki Gatanaga5, Satoshi Higasa7, Hiroshi Yatsuhashi8, Takuma Shirasaka6
1 Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
2 Department of Medical Informatics, Center for Information, Jichi Medical University, Shimotsuke, Japan
3 Fujita Health University, Toyoake, Japan
4 Department of Laboratory Medicine, Tokyo Medical University Hospital, Tokyo, Japan
5 AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
6 AIDS Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan
7 Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Japan
8 Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan


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Creative Commons License
© 2023 Kawado et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan;
E-mail: kawado@fujita-hu.ac.jp


Abstract

Background:

Most hemophiliacs living with HIV are co-infected with HCV. In their clinical practice, the long-term effects of anti-HIV and anti-HCV therapies have not been sufficiently investigated.

Objective:

This study aimed to evaluate changes in HIV RNA and HCV RNA levels and the prognosis in hemophiliacs living with HIV over 24 years in Japan.

Methods:

We used cohort study data of 578 hemophiliacs living with HIV. We analyzed trends in HIV RNA levels between the fiscal years 1997 and 2008 (first follow-up), and trends in HIV RNA and HCV RNA levels between the fiscal years 2009 and 2020 (second follow-up). Mortality rates by HIV RNA and HCV RNA levels were calculated from 11,207 observed person-years and 194 deaths.

Results:

The percentage of HIV RNA levels <400 copies/mL rose in the first period of follow-up, and the percentage of HCV RNA-negative rose in the second period of follow-up. The participants with HIV RNA levels <400 copies/mL had a significantly lower mortality rate than the others, with a ratio of 0.46 in the first period. HCV antibody-positive participants who were HCV RNA-negative had a significantly lower mortality rate than those who were HCV RNA-positive, with a ratio of 0.47 in the second period.

Conclusion:

After the introduction of combination anti-HIV therapy over 24 years in hemophiliacs living with HIV, HIV RNA levels decreased in the first half of this period, resulting in decreased mortality. Additionally, HCV RNA levels decreased in the second half of this study period, resulting in even further decreased mortality.

Keywords: HIV, AIDS, Hepatitis C virus, Hemophilia, Follow-up studies, Mortality, Antiretroviral therapy.