Risk of liver-associated morbidity and mortality in a cohort of HIV and HBV coinfected Han Chinese

Infection. 2011 Oct;39(5):427-31. doi: 10.1007/s15010-011-0145-1. Epub 2011 Jun 29.

Abstract

Objectives: To investigate the incidence and risk factors of liver-associated morbidity and mortality in Han Chinese patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection.

Methods: A retrospective study was conducted.

Results: Of the 255 subjects with HIV and HBV coinfection, 181 (71.0%) received lamivudine-based combined antiretroviral therapy (cART). Of the patients, 49/255 (19.2%) developed advanced liver diseases (ALDs) (during 5.2 years): 30 patients developed clinically overt cirrhosis, 10 developed hepatocellular carcinoma and 9 developed severe reactivation of a preexisting chronic hepatitis B. Baseline CD4(+) cell count <200 cell/mm(3) (P = 0.013, OR = 6.503), baseline alanine aminotransferase (ALT) elevation (P = 0.011, OR = 14.456), and longer cumulated time with detectable HIV RNA (P = 0.008, OR = 1.814) and HBV DNA (P = 0.014, OR = 1.536) were risk factors for ALDs development, while CD4(+) cell count changes ≥150 cells/mm(3) within 3 months (P = 0.039, OR = 0.049) and the use of lamivudine-based cART (P = 0.030, OR = 0.034) were protective against ALDs development.

Conclusions: ALDs was common among HIV and HBV coinfected Han Chinese patients. Lamivudine-based cART was beneficial in terms of sustained HBV viral suppression and resulted in less incidence of ALDs.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Anti-HIV Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • China
  • Cohort Studies
  • Coinfection / virology*
  • DNA, Viral / genetics
  • Female
  • HIV / drug effects
  • HIV / genetics
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • HIV Infections / genetics
  • HIV Infections / virology*
  • Hepatitis B / complications
  • Hepatitis B / virology*
  • Hepatitis B virus
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / virology
  • Humans
  • Lamivudine / therapeutic use*
  • Liver / pathology
  • Liver / virology
  • Male
  • Middle Aged
  • RNA, Viral / genetics
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Anti-HIV Agents
  • DNA, Viral
  • RNA, Viral
  • Lamivudine
  • Alanine Transaminase