Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting
Abstract Background There remain gaps in quantifying mortality risk among individuals co-infected with chronic hepatitis B (HBV) and human immunodeficiency virus (HIV) in sub-Saharan African contexts. Among a cohort of HIV-positive individuals in Rwanda, we estimate the difference in time-to mortali...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-022-07477-1 |
| _version_ | 1818206979354525696 |
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| author | Justine Umutesi Sabin Nsanzimana Carol Yingkai Liu Patrizio Vanella Jördis J. Ott Gérard Krause |
| author_facet | Justine Umutesi Sabin Nsanzimana Carol Yingkai Liu Patrizio Vanella Jördis J. Ott Gérard Krause |
| author_sort | Justine Umutesi |
| collection | DOAJ |
| description | Abstract Background There remain gaps in quantifying mortality risk among individuals co-infected with chronic hepatitis B (HBV) and human immunodeficiency virus (HIV) in sub-Saharan African contexts. Among a cohort of HIV-positive individuals in Rwanda, we estimate the difference in time-to mortality between HBV-positive (HIV/HBV co-infected) and HBV-negative (HIV mono-infected) individuals. Methods Using a dataset of HIV-infected adults screened for hepatitis B surface antigen (HBsAg) from January to June 2016 in Rwanda, we performed time-to-event analysis from the date of HBsAg results until death or end of study (31 December 2019). We used the Kaplan–Meier method to estimate probability of survival over time and Cox proportional hazard models to adjust for other factors associated with mortality. Results Of 21,105 available entries, 18,459 (87.5%) met the inclusion criteria. Mean age was 42.3 years (SD = 11.4) and 394 (2.1%) died during follow-up (mortality rate = 45.7 per 100,000 person-months, 95% confidence interval (CI) 41.4–50.4) Mortality rate ratio for co-infection was 1.7, 95% CI 1.1–2.6, however, Cox regression analysis did not show any association with mortality between compared groups. The adjusted analysis of covariates stratified by co-infection status showed that males, residing outside of the capital Kigali, drinking alcohol, WHO-HIV-clinical stage 3 and 4 were associated with increased mortality in this HIV cohort. Conclusions HBV infection does not significantly influence mortality among HIV-infected individuals in Rwanda. The current cohort is likely to have survived a period of high-risk exposure to HBV and HIV mortality and limited health care until their diagnosis. |
| first_indexed | 2024-12-12T04:21:38Z |
| format | Article |
| id | doaj.art-a7c450275f5f4db093b55197d5e8a517 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T04:21:38Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-a7c450275f5f4db093b55197d5e8a5172022-12-22T00:38:19ZengBMCBMC Infectious Diseases1471-23342022-05-0122111010.1186/s12879-022-07477-1Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission settingJustine Umutesi0Sabin Nsanzimana1Carol Yingkai Liu2Patrizio Vanella3Jördis J. Ott4Gérard Krause5Helmholtz Centre for Infection Research (HZI)-PhD Program “Epidemiology”Rwanda Biomedical CenterDepartment of Epidemiology, Emory University Rollins School of Public HealthDepartment of Epidemiology, Helmholtz-Zentrum Für Infektionsforschung GmbH (4214)Department of Epidemiology, Helmholtz-Zentrum Für Infektionsforschung GmbH (4214)Department of Epidemiology, Helmholtz-Zentrum Für Infektionsforschung GmbH (4214)Abstract Background There remain gaps in quantifying mortality risk among individuals co-infected with chronic hepatitis B (HBV) and human immunodeficiency virus (HIV) in sub-Saharan African contexts. Among a cohort of HIV-positive individuals in Rwanda, we estimate the difference in time-to mortality between HBV-positive (HIV/HBV co-infected) and HBV-negative (HIV mono-infected) individuals. Methods Using a dataset of HIV-infected adults screened for hepatitis B surface antigen (HBsAg) from January to June 2016 in Rwanda, we performed time-to-event analysis from the date of HBsAg results until death or end of study (31 December 2019). We used the Kaplan–Meier method to estimate probability of survival over time and Cox proportional hazard models to adjust for other factors associated with mortality. Results Of 21,105 available entries, 18,459 (87.5%) met the inclusion criteria. Mean age was 42.3 years (SD = 11.4) and 394 (2.1%) died during follow-up (mortality rate = 45.7 per 100,000 person-months, 95% confidence interval (CI) 41.4–50.4) Mortality rate ratio for co-infection was 1.7, 95% CI 1.1–2.6, however, Cox regression analysis did not show any association with mortality between compared groups. The adjusted analysis of covariates stratified by co-infection status showed that males, residing outside of the capital Kigali, drinking alcohol, WHO-HIV-clinical stage 3 and 4 were associated with increased mortality in this HIV cohort. Conclusions HBV infection does not significantly influence mortality among HIV-infected individuals in Rwanda. The current cohort is likely to have survived a period of high-risk exposure to HBV and HIV mortality and limited health care until their diagnosis.https://doi.org/10.1186/s12879-022-07477-1Chronic hepatitis BMortalityHIVCohort studySub-Saharan AfricaRwanda |
| spellingShingle | Justine Umutesi Sabin Nsanzimana Carol Yingkai Liu Patrizio Vanella Jördis J. Ott Gérard Krause Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting BMC Infectious Diseases Chronic hepatitis B Mortality HIV Cohort study Sub-Saharan Africa Rwanda |
| title | Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting |
| title_full | Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting |
| title_fullStr | Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting |
| title_full_unstemmed | Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting |
| title_short | Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting |
| title_sort | long term effect of chronic hepatitis b on mortality in hiv infected persons in a differential hbv transmission setting |
| topic | Chronic hepatitis B Mortality HIV Cohort study Sub-Saharan Africa Rwanda |
| url | https://doi.org/10.1186/s12879-022-07477-1 |
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