Hepatitis B and C co-infection in HIV patients from the TREAT Asia HIV observational database: Analysis of risk factors and survival

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 ChoiShinichi Oka, Pacharee Kantipong, Mahiran Mustafa, Winai Ratanasuwan, Nicolas Durier, Yi Ming Arthur Chen

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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/orHCV 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.

Original languageEnglish
Article numbere0150512
JournalPloS one
Volume11
Issue number3
DOIs
Publication statusPublished - 2016 Mar

Bibliographical note

Funding Information:
The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and National Cancer Institute, as part of the International Epidemiologic Databases to Evaluate AIDS (IeDEA; U01AI069907), and the Dutch Ministry of Foreign Affairs through a partnership with Stichting Aids Fonds. The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Australia (The University of New South Wales). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the government or institutions mentioned above.

Publisher Copyright:
© 2016 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

All Science Journal Classification (ASJC) codes

  • General

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