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Spontaneous hepatic decompensation was observed in 7 of 383 patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) who were receiving treatment with interferon and ribavirin. Multivariate analysis identified the following risk factors: didanosine use (odds ratio [OR], 8.8; 95% confidence interval [CI], 1.2-102.3; P &lt; .02), cirrhosis, (OR, 8.8; 95% CI, 1.2-104.2; P&lt;.02), and elevated total bilirubin level (OR, 7.9; 95% CI, 1.08-93.3; P&lt;.03). Didanosine should thus not be given to patients with cirrhosis, particularly when treatments for HCV and HIV infections have to be administered concomitantly.

Spontaneous Hepatic Decompensation in Patients Coinfected with HIV and Hepatitis C Virus during Interferon-Ribavirin Combination Treatment