Open AccessSystematic review and meta‐analysis of hepatitis C virus infection and HIV viral load: new insights into epidemiologic synergy
Author(s) -
Petersdorf Nicholas,
Ross Jennifer M,
Weiss Helen A,
Barnabas Ruanne V,
Wasserheit Judith N
Publication year - 2016
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.19.1.20944
Subject(s) - medicine , transmission (telecommunications) , hepatitis c virus , viral load , virology , ribavirin , meta analysis , hepatitis c , immunology , human immunodeficiency virus (hiv) , epidemiology , coinfection , virus , electrical engineering , engineering
Hepatitis C virus (HCV) and HIV infection frequently co‐occur due to shared transmission routes. Co‐infection is associated with higher HCV viral load (VL), but less is known about the effect of HCV infection on HIV VL and risk of onward transmission. Methods We undertook a systematic review comparing 1) HIV VL among ART‐naïve, HCV co‐infected individuals versus HIV mono‐infected individuals and 2) HIV VL among treated versus untreated HCV co‐infected individuals. We performed a random‐effects meta‐analysis and quantified heterogeneity using the I 2 statistic. We followed Cochrane Collaboration guidelines in conducting our review and PRISMA guidelines in reporting results. Results and discussion We screened 3925 articles and identified 17 relevant publications. A meta‐analysis found no evidence of increased HIV VL associated with HCV co‐infection or between HIV VL and HCV treatment with pegylated interferon‐alpha‐2a/b and ribavirin. Conclusions This finding is in contrast to the substantial increases in HIV VL observed with several other systemic infections. It presents opportunities to elucidate the biological pathways that underpin epidemiological synergy in HIV co‐infections and may enable prediction of which co‐infections are most important to epidemic control.