Hepatitis B and C virus coinfection in the TREAT Asia HIV Observational Database

Jialun Zhou, Gregory J. Dore, Fujie Zhang, Poh Lian Lim, Yi Ming A. Chen

Research output: Contribution to journalArticle

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Abstract

Background and Aim: Most studies of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection with HIV have been conducted among Western patient populations. This study aims to assess rates of HBV and HCV coinfection, and their impact on response to antiretroviral therapy and mortality, using data from The TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of patients with HIV in the Asia-Pacific region. Methods: Patients who had been tested either HBV surface antigen (HBsAg) or HCV antibody were included. Patients who ever tested positive for HBV or HCV were regarded as coinfected for the duration of the study. Results: Results of hepatitis tests were available for 55% (HBV) and 49% (HCV) of 2979 TAHOD patients, with prevalence of HBV and HCV coinfection both at approximately 10%. Mean CD4 change at 180 days after antiretroviral treatment initiation was 118.8 cells/μL and patients with either HBV or HCV had a lower but non-significant CD4 increase compared with patients with HIV only. Median time to reach undetectable viral load (<400 copies/mL) was 148 days and was not independently associated with HBV or HCV. In univariate analysis, patients with HCV had increased mortality (unadjusted hazard ratio, HR 2.80, P = 0.007). However, neither HBV (adjusted HR 0.80, 95% confidence interval CI 0.24-2.64, P = 0.710) nor HCV (adjusted HR 1.06, 95% CI 0.40-2.79, P = 0.905) was associated with increased mortality after adjustment for other covariates. Both HBV and HCV remained independently associated with elevated alanine aminotransferase (ALT) in the multivariate model (HBV, adjusted HR 1.94, 95% CI 1.04-3.62, P = 0.037; HCV, adjusted HR 2.74, 95% CI 1.47-5.12, P = 0.002). Conclusion: The impact of hepatitis coinfection on immunological and virological responses to antiretroviral therapy and HIV disease progression among this Asian cohort are similar to that seen in Western countries. The longer-term impact of hepatitis coinfection on both HIV disease and liver disease morbidity and mortality needs to be monitored.

Original languageEnglish
Pages (from-to)1510-1518
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume22
Issue number9
DOIs
Publication statusPublished - Jan 1 2007
Externally publishedYes

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Coinfection
Hepatitis B virus
Hepacivirus
HIV
Databases
Hepatitis
Mortality
Hepatitis C Antibodies
Hepatitis B Surface Antigens
Viral Load
Alanine Transaminase
Disease Progression
Liver Diseases
Therapeutics
Confidence Intervals
Morbidity

Keywords

  • Asia and Pacific
  • Coinfection
  • Hepatitis
  • HIV/AIDS
  • Observational study

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Hepatitis B and C virus coinfection in the TREAT Asia HIV Observational Database. / Zhou, Jialun; Dore, Gregory J.; Zhang, Fujie; Lim, Poh Lian; Chen, Yi Ming A.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 22, No. 9, 01.01.2007, p. 1510-1518.

Research output: Contribution to journalArticle

Zhou, Jialun ; Dore, Gregory J. ; Zhang, Fujie ; Lim, Poh Lian ; Chen, Yi Ming A. / Hepatitis B and C virus coinfection in the TREAT Asia HIV Observational Database. In: Journal of Gastroenterology and Hepatology (Australia). 2007 ; Vol. 22, No. 9. pp. 1510-1518.
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AU - Chen, Yi Ming A.

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N2 - Background and Aim: Most studies of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection with HIV have been conducted among Western patient populations. This study aims to assess rates of HBV and HCV coinfection, and their impact on response to antiretroviral therapy and mortality, using data from The TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of patients with HIV in the Asia-Pacific region. Methods: Patients who had been tested either HBV surface antigen (HBsAg) or HCV antibody were included. Patients who ever tested positive for HBV or HCV were regarded as coinfected for the duration of the study. Results: Results of hepatitis tests were available for 55% (HBV) and 49% (HCV) of 2979 TAHOD patients, with prevalence of HBV and HCV coinfection both at approximately 10%. Mean CD4 change at 180 days after antiretroviral treatment initiation was 118.8 cells/μL and patients with either HBV or HCV had a lower but non-significant CD4 increase compared with patients with HIV only. Median time to reach undetectable viral load (<400 copies/mL) was 148 days and was not independently associated with HBV or HCV. In univariate analysis, patients with HCV had increased mortality (unadjusted hazard ratio, HR 2.80, P = 0.007). However, neither HBV (adjusted HR 0.80, 95% confidence interval CI 0.24-2.64, P = 0.710) nor HCV (adjusted HR 1.06, 95% CI 0.40-2.79, P = 0.905) was associated with increased mortality after adjustment for other covariates. Both HBV and HCV remained independently associated with elevated alanine aminotransferase (ALT) in the multivariate model (HBV, adjusted HR 1.94, 95% CI 1.04-3.62, P = 0.037; HCV, adjusted HR 2.74, 95% CI 1.47-5.12, P = 0.002). Conclusion: The impact of hepatitis coinfection on immunological and virological responses to antiretroviral therapy and HIV disease progression among this Asian cohort are similar to that seen in Western countries. The longer-term impact of hepatitis coinfection on both HIV disease and liver disease morbidity and mortality needs to be monitored.

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