Chronic hepatitis B increases mortality and complexity among HIV-coinfected patients in South Africa: a cohort study

HIV Med. 2016 Oct;17(9):702-7. doi: 10.1111/hiv.12367. Epub 2016 Mar 17.

Abstract

Objectives: To assess the effect of chronic hepatitis B on survival and clinical complexity among people living with HIV following antiretroviral therapy (ART) initiation.

Methods: We evaluated mortality and single-drug substitutions up to 3 years from ART initiation (median follow-up 2.75 years; interquartile range 2-3 years) among patients with and without chronic hepatitis B (CHB) enrolled in a workplace HIV care programme in South Africa.

Results: Mortality was increased for CHB patients with hepatitis B virus (HBV) DNA levels > 10 000 copies/mL (adjusted hazard ratio 3.1; 95% confidence interval 1.2-8.0) compared with non-CHB patients. We did not observe a similar difference between non-CHB patients and those with CHB and HBV DNA < 10 000 copies/mL (adjusted hazard ratio 0.70; 95% confidence interval 0.2-2.3). Single-drug substitutions occurred more frequently among coinfected patients regardless of HBV DNA level.

Conclusions: Our findings suggest that CHB may increase mortality and complicate ART management.

Keywords: Africa; HIV; antiretroviral therapy; hepatitis B; mortality.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Africa
  • Anti-Retroviral Agents / therapeutic use*
  • Cohort Studies
  • Coinfection / mortality*
  • Female
  • Follow-Up Studies
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / mortality*
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / mortality*
  • Humans
  • Male
  • Middle Aged
  • South Africa / epidemiology

Substances

  • Anti-Retroviral Agents