Treatment outcomes of HIV patients with hepatitis B and C virus co-infections in Southwest China: an observational cohort study

• 作者: Jia Jingya Zhu Qiuying Deng Luojia Lan Guanghua Johnson Andrew Chen Huanhuan Shen Zhiyong Li Jianjun Xing Hui Ruan Yuhua Li Jing Lu Hui Vermund Sten H. Zhu Jinhui Qian Han-Zhu
• 来源期刊: 贫困所致传染病（英文）
• 关键词: Hepatitis C virus Hepatitis B virus HIV Antiretroviral therapy Mortality Retrospective cohort
• 年，卷（期）: 2022,（1）
• 所属期刊栏目: Research Article
• 页码范围: 27-33
• 页数: 7页
• 语种: 中文
• DOI: 10.1186/s40249-021-00921-5

摘要

Background::Antiretroviral therapy (ART) has reduced mortality among people living with HIV (PLWH) in China, but co-infections of hepatitis B virus (HBV) and hepatitis C virus (HCV) may individually or jointly reduce the effect of ART. This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART.Methods::A retrospective cohort study analysis of 58,239 people living with HIV (PLWH) who initiated antiretroviral therapy (ART) during 2010-2018 was conducted in Guangxi Province, China. Data were from the observational database of the National Free Antiretroviral Treatment Program. Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH.Results::Our study showed high prevalence of HBV (11.5%), HCV (6.6%) and HBV-HCV (1.5%) co-infections. The overall mortality rate and treatment attrition rate was 2.95 [95% confidence interval ( CI): 2.88-3.02] and 5.92 (95% CI: 5.82-6.01) per 100 person-years, respectively. Compared with HIV-only patients, HBV-co-infected patients had 42% higher mortality [adjusted hazard ratio (a HR)=1.42; 95% CI 1.32-1.54], HCV-co-infected patients had 65% higher mortality (a HR=1.65; 95% CI: 1.47-1.86), and patients with both HCV and HBV co-infections had 123% higher mortality (a HR=2.23; 95% CI:1.87-2.66). Conclusions::HBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART. It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH.