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

K Velen1, S Charalambous1,2, C Innes1

  • 1The Aurum Institute, Johannesburg, South Africa.

HIV Medicine
|March 19, 2016
PubMed

Insights

Chronic hepatitis B (CHB) increases mortality risk in people with HIV and high viral loads. CHB also complicates antiretroviral therapy (ART) management, leading to more treatment changes.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Virology

Background:

  • People living with HIV (PLWHIV) often have co-infections, including chronic hepatitis B (CHB).
  • Antiretroviral therapy (ART) is crucial for managing HIV but its interaction with CHB requires further investigation.

Purpose of the Study:

  • To evaluate the impact of CHB on survival and ART complexity in PLWHIV.
  • To determine if HBV DNA levels influence mortality risk in coinfected individuals.

Main Methods:

  • A cohort of PLWHIV in South Africa was assessed for mortality and ART modifications.
  • Patients were categorized based on the presence and hepatitis B virus (HBV) DNA levels of CHB.
  • Follow-up extended up to 3 years post-ART initiation.

Main Results:

  • Mortality was significantly higher in CHB patients with HBV DNA > 10,000 copies/mL.
  • No increased mortality was observed in CHB patients with HBV DNA < 10,000 copies/mL compared to non-CHB patients.
  • Coinfected patients experienced more single-drug substitutions, irrespective of HBV DNA levels.

Conclusions:

  • CHB is associated with increased mortality risk in PLWHIV, particularly with high viral loads.
  • CHB complicates ART management, necessitating more frequent treatment adjustments.
Abstract

Keywords:
AfricaHIVantiretroviral therapyhepatitis Bmortality

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