Distinct Hepatitis B and HIV co‐infected populations in Canada

Autor:	Carla Osiowy, David Wong, Abdel Aziz M. Shaheen, Philip Wong, Giada Sebastiani, Karen Doucette, Scott Fung, Brian Conway, Sarah Haylock-Jacobs, Lisa Barrett, Gerald Y. Minuk, Alnoor Ramji, Carla S. Coffin, Matt Driedger, Alexander Wong, Curtis Cooper
Rok vydání:	2021
Předmět:	Male Canada Hepatitis B virus medicine.medical_specialty Cirrhosis Population Ethnic group HIV Infections 03 medical and health sciences Liver disease 0302 clinical medicine Virology Internal medicine Epidemiology Prevalence medicine Humans 030212 general & internal medicine education education.field_of_study Hepatology Coinfection business.industry Infant Newborn virus diseases Hepatitis B medicine.disease Comorbidity digestive system diseases Cross-Sectional Studies Infectious Diseases Cohort 030211 gastroenterology & hepatology business
Zdroj:	Journal of Viral Hepatitis. 28:517-527
ISSN:	1365-2893 1352-0504
DOI:	10.1111/jvh.13453
Popis:	Due to shared modes of exposure, HIV-HBV co-infection is common worldwide. Increased knowledge of the demographic and clinical characteristics of the co-infected population will allow us to optimize our approach to management of both infections in clinical practice. The Canadian Hepatitis B Network Cohort was utilized to conduct a cross-sectional evaluation of the demographic, biochemical, fibrotic and treatment characteristics of HIV-HBV patients and a comparator HBV group. From a total of 5996 HBV-infected patients, 335 HIV-HBV patients were identified. HIV-HBV patients were characterized by older median age, higher male and lower Asian proportion, more advanced fibrosis and higher anti-HBV therapy use (91% vs. 30%) than the HBV-positive / HIV seronegative comparator group. A history of reported high-risk exposure activities (drug use, high-risk sexual contact) was more common in HIV-HBV patients. HIV-HBV patients with reported high-risk exposure activities had higher male proportion, more Caucasian ethnicity and higher prevalence of cirrhosis than HIV-HBV patients born in an endemic country. In the main cohort, age ≥60 years, male sex, elevated ALT, the presence of comorbidity and HCV seropositivity were independent predictors of significant fibrosis. HIV seropositivity was not an independent predictor of advanced fibrosis (adj OR 0.75 [95%CI: 0.34-1.67]). In conclusion, Canadian co-infected patients differed considerably from those with mono-infection. Furthermore, HIV-HBV-infected patients who report high-risk behaviours and those born in endemic countries represent two distinct subpopulations, which should be considered when engaging these patients in care.
Databáze:	OpenAIRE
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