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PLoS One. 2016 Mar 2;11(3):e0150512. doi: 10.1371/journal.pone.0150512. eCollection 2016.

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

Author information

1
Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
2
Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.
3
Department of Cosmetic Applications and Management, MacKay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan.
4
Department of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Taiwan.
5
The Kirby Institute, UNSW Australia, Sydney, Australia.
6
Division of Infectious Diseases, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
7
Working Group on AIDS Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
8
Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia.
9
Tan Tock Seng Hospital, Singapore, Singapore.
10
Research Institute for Health Sciences, Chiang Mai, Thailand.
11
HIV-NAT/ Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
12
Queen Elizabeth Hospital, Hong Kong, China.
13
Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India.
14
National Center for HIV/AIDS, Dermatology & STDs, and University of Health Sciences, Phnom Penh, Cambodia.
15
Research Institute for Tropical Medicine, Manila, Philippines.
16
Hospital Sungai Buloh, Sungai Buloh, Malaysia.
17
National Hospital for Tropical Diseases, Hanoi, Vietnam.
18
Institute of Infectious Diseases, Pune, India.
19
University Malaya Medical Centre, Kuala Lumpur, Malaysia.
20
Beijing Ditan Hospital, Capital Medical University, Beijing, China.
21
Bach Mai Hospital, Hanoi, Vietnam.
22
Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
23
National Center for Global Health and Medicine, Tokyo, Japan.
24
Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
25
Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia.
26
Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
27
TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand.
28
Department of Microbiology and Institute of Medical Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

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.

PMID:
26933963
PMCID:
PMC4774987
DOI:
10.1371/journal.pone.0150512
[Indexed for MEDLINE]
Free PMC Article

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