Individually, HIV infection and chronic hepatitis C (HCV) and the inflammatory state associated with both can accelerate aging, worsen quality of life, and increase the risk of chronic conditions such as geriatric syndromes (GS) and depression. Data on the impact of HIV/HCV coinfection on these outcomes are still limited. We evaluated the prevalence of HCV among people living with HIV/AIDS (PLWHA) in the ELEA-Brazil cohort and its association with GS, depression, and quality of life.

Cross-sectional study with PLWHA ≥ 50 years with viral suppression in three Brazilian cities. We defined HCV by persistence of detectable HCV RNA ≥ 6 months, or any history of treatment for HCV. Sociodemographic and clinical variables were compared between individuals with and without HCV using chi-square and Wilcoxon tests. GS included pre-frailty/frailty (Fried phenotype ≥ 1), sarcopenia (Short Physical Performance Battery ≤ 9), cognitive impairment (Montreal Cognitive Assessment < 26), falls in the last 12 months, depression (Patient Health Questionnaire-9 ≥ 10) and quality of life (EQ-5D-5L). We used multivariable logistic regression and cumulative probability regression to evaluate the association between HCV and GS, including confounders such as age, sex, race, CD4 count/nadir, obesity, and time since HIV diagnosis.

Of the 702 participants in the cohort, 669 were tested for HCV and included. Median age 62 years; 65% were men and 55% non-white. The prevalence of HCV was 10.6% (n = 71). Compared to PLWHA without HCV, those with HCV showed longer time of HIV infection and lower monthly income. The prevalence of geriatric syndromes was similar between the groups with only HIV and coinfected: cognitive impairment (73% vs. 69%, p = 0.50), sarcopenia (38% vs. 42%, p = 0.50), frailty/pre-frailty (54% vs. 55%, p > 0.90), falls (21% vs. 21%, p>0.90), depression (16% vs. 18%, p = 0.20) and median quality-of-life index (0.96 vs. 0.94, p = 0.12). In multivariable analyses, HIV/HCV coinfection was not statistically associated with any GS (p > 0.05 for all models).

Although the prevalence of HCV and of geriatric syndromes was high in our study, we did not find statistically significant differences between the groups with isolated HIV infection and with HIV-HCV coinfection, perhaps justified by the small number of coinfected with advanced disease.