To investigate the clinical characteristics and treatment status of patients with hepatitis C virus (HIV) and human immunodeficiency virus (HIV) infection, and to provide scientific guidance for HIV/HCV co-infection treatment.

Based on real-world data from hospital information system, medical records of 167 patients with HIV/acquired immune deficiency syndrome (AIDS) from the Sixth People’s Hospital of Xinjiang Uygur Autonomous Region (Infectious Diseases Hospital) and Xinjiang Uygur Autonomous Region People’s Hospital were collected from May 2008 to May 2018. According to medical records, patients with HIV/HCV co-infection were divided into polyethylene glycol interferon-α-2b (PegIFNα-2b) and ribavirin (RBV) treatment group (PegIFN group: 62 cases), common IFN and RBV treatment group (IFN group: 46 cases) and direct acting antivirals (DAAs) treatment group (DAAs group: 59 cases). The changes of CD4⁺ T lymphocytes, alanine transaminase (ALT), aspartate transaminase (AST), virological response and adverse reactions in the three groups were analyzed, respectivly.

Total of 659 cases with HIV/AIDS were collected, among which, 167 cases were complicated with HCV infection, the complicated infection rate was 25.34%. The main HCV genotypes were type 3b (43 cases), type 3a (41 cases), type 1b (32 cases), type 6a (21 cases), undifferentiated subtype (25 cases), type 2a (5 cases); among which type 3 was the most, accounting for 50.29% (84/167). Among them, intravenous drug use accounted for 29.40% (142/483), sexual transmission accounted for 14.20% (23/162) and others accounted for 14.29% (2/14). Total of 125 patients had no obvious symptoms, and 42 patients had symptoms such as weakness, fever, night sweats, liver cirrhosis and lymphadenopathy. Liver function detection showed that 56 cases (56/167, 33.5%) were with normal liver function, 111 cases (111/167, 66.5%) with abnormal liver function, including 12 cases with cirrhosis in compensatory stage, 7 cases with degeneration of cirrhosis repayment period. The HIV/HCV coinfection rate dropped from 37.25% in 2008 to 15.00% in 2018, which showed a downward trend year by year (χ² = 263.190, P < 0.001). The CD4⁺ T cell count of patients with HIV/HCV coinfection was significantly higher than that of patients with HIV/AIDS (t = 7.203, P < 0.001); but total bilirubin (TBil) (t = 29.101, P < 0.001), ALT (t = 25.382, P < 0.001), AST (t = 30.984, P < 0.001), HIV RNA (t = 9.190, P < 0.001) were significantly lower than those of patients with HIV/AIDS, all with significant differences. The amounts of CD4⁺ T lymphocytes in each group after treatment were higher than those before treatment, which was higher of patients in DAAs group than those of PegIFN group and IFN group; the levels of ALT and AST after treatment in three groups were lower than those before treatment, which higher of DAAs group was than those of in PegIFN group and IFN group, all with significant differences (CD4⁺ T: F = 4.252, P = 0.016; ALT: F = 125.400, P < 0.001; AST: F = 37.990, P < 0.001). The early virological response (EVR) rate (96.61%) of patients in DAAs group was significantly higher than that of PegIFN group (77.42%) and IFN group (71.74%); the end of treatment virological response (ETVR) rate (96.61%) of patients in DAAs group was significantly higher in PegIFN group (72.58%) and IFN group (63.04%). The sustained virological response (SVR) rate (94.92%) of DAAs group was significantly higher than those of PegIFN group (69.35%) and IFN group (67.39%), all with significant differences (EVR: χ² = 13.011, P = 0.001; ETVR: χ² = 19.227, P < 0.001; SVR: χ² = 14.474, P < 0.001). The incidence of adverse reactions such as fatigue, fever, decreased white blood cells, decreased hemoglobin and decreased platelets of patients in DAAs group were significantly lower than those of PegIFN group and IFN group, with significant differences (fatigue: χ² = 6.678, P = 0.035; fever: χ² = 12.485, P = 0.002; decreased white blood cell: χ² = 10.256, P = 0.006; decreased hemoglobin: χ² = 13.962, P = 0.001; decreased platelet: χ² = 11.681, P = 0.003).

The HIV/HCV coinfection rate was high, with HCV genotype 3 the most common, showing a year-on-year downward trend, and spreading mainly through intravenous drug use. DAAs for HIV/HCV co-infected patients were more conducive to the recovery of immune function and liver function, with a higher SVR rate and higher safety.