Hepatitis C/HIV co‐infection is associated with higher mortality in hospitalized patients with Hepatitis C or HIV

Summary.  Up to 10% of all patients with Hepatitis C virus (HCV) infection are co‐infected with human immunodeficiency virus (HIV); 25–30% of HIV patients are co‐infected with HCV. The aim of this study was to examine the association of HCV/HIV co‐infection with outcomes of hospitalized patients compared to those with HCV or HIV monoinfection. Using the 2006 Nationwide Inpatient Sample, patients with HCV or HIV monoinfection or HCV/HIV co‐infection were identified using ICD‐9‐CM codes. We compared liver‐related and infection‐related admission between the three groups of patients. Multivariate logistic regression was performed to identify independent predictors of in‐hospital mortality. A total of 474 843 discharges with HCV monoinfection, 206 758 with HIV monoinfection and 56 304 with HCV/HIV co‐infection were included. Liver‐related admissions were more common in co‐infected patients (15.4%) compared to those with HIV monoinfection (3.3%, P  < 0.001). Primary infectious hospitalizations were more common in HIV monoinfection (33.9%) compared to co‐infected patients (26%, P  < 0.001). HCV/HIV co‐infection was associated with higher mortality compared to HCV monoinfection (OR 1.41, 95% CI 1.20–1.65) but not when compared to monoinfected‐HIV patients. HCV‐associated cirrhosis or complications thereof conferred four times greater mortality risk in patients with HIV (OR 3.96, 95% CI 3.29–4.79). The rate of hospitalization for HCV/HIV co‐infected patients (23.5%) was significantly higher than those with HCV (14.8%) or HIV (19.9%) ( P  < 0.001). HCV/HIV co‐infection is associated with significantly higher rates of hospitalization and is a risk factor for in‐hospital mortality compared to patients with isolated HCV.