Hepatitis B and C Co-Infection in HIV Patients from the TREAT Asia HIV Observational Database: Analysis of Risk Factors and Survival.

Abstract

BACKGROUND:

We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region.

METHODS:

Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test.

RESULTS:

A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive.

CONCLUSION:

In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality.

• Authors: Marcelo Chen, Wing-Wai Wong, Matthew G Law, Sasisopin Kiertiburanakul, Evy Yunihastuti, Tuti Parwati Merati, Poh Lian Lim, Romanee Chaiwarith, Praphan Phanuphak, Man Po Lee, Nagalingeswaran Kumarasamy, Vonthanak Saphonn, Rossana Ditangco, Benedict L H Sim, Kinh Van Nguyen, Sanjay Pujari, Adeeba Kamarulzaman, Fujie Zhang, Thuy Thanh Pham, Jun Yong Choi, Shinichi Oka, Pacharee Kantipong, Mahiran Mustafa, Winai Ratanasuwan, Nicolas Durier, Yi-Ming Arthur Chen
• Journal: PloS one (PLoS One) Vol. 11 Issue 3 Pg. e0150512 ( 2016) ISSN: 1932-6203 [Electronic] United States
• PMID: 26933963 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Retroviral Agents

Topics

• Adult
• Anti-Retroviral Agents (therapeutic use)
• Antiretroviral Therapy, Highly Active
• Asia (epidemiology)
• CD4 Lymphocyte Count
• Cohort Studies
• Coinfection (complications, epidemiology)
• Female
• HIV Infections (complications, drug therapy, epidemiology)
• HIV-1 (drug effects, isolation & purification)
• Hepatitis B (complications, epidemiology)
• Hepatitis C (complications, epidemiology)
• Humans
• Male
• Middle Aged
• Risk Factors
• Survival Analysis
• Treatment Outcome