Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada
| Autor: | Urvi Rana, Alexander Wong, Réjean Thomas, Sharon Walmsley, Nima Machouf, Marie-Hélène Roy-Gagnon, Marina B. Klein, Stephen E. Sanche, Erin Ding, Curtis Cooper, Paul Sereda, Deborah V. Kelly, Matt Driedger, Mona Loutfy, Shenyi Pan, Robert S. Hogg, Abigail Kroch |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Hepatitis B virus medicine.medical_specialty Anti-HIV Agents Population HIV Infections Antiviral Agents lcsh:Infectious and parasitic diseases 03 medical and health sciences symbols.namesake 0302 clinical medicine Risk Factors Internal medicine Epidemiology Prevalence medicine Humans lcsh:RC109-216 030212 general & internal medicine education Fisher's exact test Retrospective Studies Ontario education.field_of_study British Columbia Coinfection business.industry Mortality rate Quebec HIV virus diseases Retrospective cohort study Middle Aged Hepatitis B medicine.disease Co-infection 3. Good health Infectious Diseases Cohort symbols Female 030211 gastroenterology & hepatology Observational study business Research Article |
| Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-10 (2019) |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-019-4617-8 |
| Popis: | BackgroundHepatitis B (HBV) and Human Immunodeficiency Virus (HIV) share common risk factors for exposure. Co-infected patients have an increased liver-related mortality risk and may have accelerated HIV progression. The epidemiology and demographic characteristics of HIV-HBV co-infection in Canada remain poorly defined. We compared the demographic and clinical characteristics and factors associated with advanced hepatic fibrosis between HIV and HIV-HBV co-infected patients.MethodsA retrospective cohort analysis was conducted using data from the Canadian Observational Cohort (CANOC) Collaboration, including eight sites from British Columbia, Quebec, and Ontario. Eligible participants were HIV-infected patients who initiated combination ARV between January 1, 2000 and December 14, 2014. Demographic and clinical characteristics were compared between HIV-HBV co-infected and HIV-infected groups using chi-square or Fisher exact tests for categorical variables, and Wilcoxon’s Rank Sum test for continuous variables. Liver fibrosis was estimated by the AST to Platelet Ratio Index (APRI).ResultsHBV status and APRI values were available for 2419 cohort participants. 199 (8%) were HBV co-infected. Compared to HIV-infected participants, HIV-HBV co-infected participants were more likely to use injection drugs (28% vs. 21%,p = 0.03) and be HCV-positive (31%, vs. 23%,p = 0.02). HIV-HBV co-infected participants had lower baseline CD4 T cell counts (188 cells/mm3, IQR: 120–360) compared to 235 cells/mm3in HIV-infected participants (IQR: 85–294) (p = 0.0002) and higher baseline median APRI scores (0.50 vs. 0.37,p p = 0.03). HIV-HBV co-infected participants had a higher mortality rate compared to HIV-infected participants (11% vs. 7%,p = 0.02).ConclusionThe prevalence, demographic and clinical characteristics of the HIV-HBV co-infected population in Canada is described. HIV-HBV co-infected patients have higher mortality, more advanced CD4 T cell depletion, and liver fibrosis that improves in conjunction with ARV therapy. The high prevalence of unknown HBV status demonstrates a need for increased screening among HIV-infected patients in Canada. |
| Databáze: | OpenAIRE |
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