Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada
Abstract Background Hepatitis 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...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4617-8 |
| _version_ | 1818935305119465472 |
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| author | Urvi Rana Matt Driedger Paul Sereda Shenyi Pan Erin Ding Alex Wong Sharon Walmsley Marina Klein Deborah Kelly Mona Loutfy Rejean Thomas Stephen Sanche Abigail Kroch Nima Machouf Marie-Helene Roy-Gagnon Robert Hogg Curtis L. Cooper The Canadian Observational Cohort (CANOC) Collaboration |
| author_facet | Urvi Rana Matt Driedger Paul Sereda Shenyi Pan Erin Ding Alex Wong Sharon Walmsley Marina Klein Deborah Kelly Mona Loutfy Rejean Thomas Stephen Sanche Abigail Kroch Nima Machouf Marie-Helene Roy-Gagnon Robert Hogg Curtis L. Cooper The Canadian Observational Cohort (CANOC) Collaboration |
| author_sort | Urvi Rana |
| collection | DOAJ |
| description | Abstract Background Hepatitis 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. Methods A 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). Results HBV 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/mm3 in HIV-infected participants (IQR: 85–294) (p = 0.0002) and higher baseline median APRI scores (0.50 vs. 0.37, p < 0.0001). This difference in APRI was no longer clinically significant at follow-up (0.32 vs. 0.30, p = 0.03). HIV-HBV co-infected participants had a higher mortality rate compared to HIV-infected participants (11% vs. 7%, p = 0.02). Conclusion The 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. |
| first_indexed | 2024-12-20T05:18:03Z |
| format | Article |
| id | doaj.art-816d216f5f324055af43f38d3fb908f4 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-20T05:18:03Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-816d216f5f324055af43f38d3fb908f42022-12-21T19:52:06ZengBMCBMC Infectious Diseases1471-23342019-11-0119111010.1186/s12879-019-4617-8Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in CanadaUrvi Rana0Matt Driedger1Paul Sereda2Shenyi Pan3Erin Ding4Alex Wong5Sharon Walmsley6Marina Klein7Deborah Kelly8Mona Loutfy9Rejean Thomas10Stephen Sanche11Abigail Kroch12Nima Machouf13Marie-Helene Roy-Gagnon14Robert Hogg15Curtis L. Cooper16The Canadian Observational Cohort (CANOC) CollaborationSchool of Epidemiology and Public Health, University of OttawaDepartment of Medicine, University of OttawaBC Centre for Excellence in HIV/AIDSBC Centre for Excellence in HIV/AIDSBC Centre for Excellence in HIV/AIDSRegina Qu’Appelle Health RegionUniversity Health NetworkResearch Institute of McGill University Health CentreMemorial University of NewfoundlandMaple Leaf Medical ClinicClinique Medicale l’ActuelDepartment of Medicine, University of SaskatchewanThe Ontario HIV Treatment NetworkClinique de Médicine Urbaine du Quartier LatinSchool of Epidemiology and Public Health, University of OttawaBC Centre for Excellence in HIV/AIDSSchool of Epidemiology and Public Health, University of OttawaAbstract Background Hepatitis 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. Methods A 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). Results HBV 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/mm3 in HIV-infected participants (IQR: 85–294) (p = 0.0002) and higher baseline median APRI scores (0.50 vs. 0.37, p < 0.0001). This difference in APRI was no longer clinically significant at follow-up (0.32 vs. 0.30, p = 0.03). HIV-HBV co-infected participants had a higher mortality rate compared to HIV-infected participants (11% vs. 7%, p = 0.02). Conclusion The 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.http://link.springer.com/article/10.1186/s12879-019-4617-8Co-infectionHepatitis BHIVPrevalence |
| spellingShingle | Urvi Rana Matt Driedger Paul Sereda Shenyi Pan Erin Ding Alex Wong Sharon Walmsley Marina Klein Deborah Kelly Mona Loutfy Rejean Thomas Stephen Sanche Abigail Kroch Nima Machouf Marie-Helene Roy-Gagnon Robert Hogg Curtis L. Cooper The Canadian Observational Cohort (CANOC) Collaboration Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada BMC Infectious Diseases Co-infection Hepatitis B HIV Prevalence |
| title | Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada |
| title_full | Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada |
| title_fullStr | Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada |
| title_full_unstemmed | Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada |
| title_short | Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada |
| title_sort | characteristics and outcomes of antiretroviral treated hiv hbv co infected patients in canada |
| topic | Co-infection Hepatitis B HIV Prevalence |
| url | http://link.springer.com/article/10.1186/s12879-019-4617-8 |
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