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Syndemic Characterization of HCV, HBV, and HIV Co-infections in a Large Population Based Cohort Study

Geoffrey McKee1, Zahid A Butt1,2, Stanley Wong1,2

  • 1School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.

Eclinicalmedicine
|June 14, 2019
PubMed

Insights

Understanding co-infections like Hepatitis B, C, and HIV is crucial. This study analyzed population data to find unique risk factors for different co-infection groups, informing targeted health services.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Limited data exist on Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Immunodeficiency Virus (HIV) co-infections and triple infections.
  • Population-level characterization of these co-infections is essential for understanding unique predisposing factors.

Purpose of the Study:

  • To characterize the co-occurrence of HIV, HBV, and HCV infections in British Columbia.
  • To identify distinct patterns of predisposing factors associated with various co-infection subgroups.

Main Methods:

  • Analysis of the BC Hepatitis Testers Cohort (1992-2013) and provincial registries.
  • Classification of individuals into negative, mono-infection, and co-infection groups (HIV, HBV, HCV).
  • Multivariate multinomial logistic regression to assess associations between risk factors (e.g., injection drug use, sexual orientation) and co-infection groups.

Main Results:

  • Over 1.3 million individuals analyzed; 100,699 had at least one infection.
  • Monoinfections were most common (90.8%), followed by HBV/HCV (4.0%), HCV/HIV (3.4%), HBV/HIV (0.7%), and HBV/HCV/HIV (1.2%).
  • Men who have sex with men (MSM) showed higher odds of HIV co-infections, especially HBV/HIV (OR 6.8). Injection drug use strongly correlated with triple infection (OR 64.19) and HIV/HCV (OR 23.23).

Conclusions:

  • Syndemics of substance use, sexual practices, mental illness, and socioeconomic factors interact with co-infections.
  • Distinct population groups exhibit unique syndemic profiles.
  • Health services require tailored composition and context to address the specific needs of each population group effectively.
Abstract

Keywords:
Co-infectionHIVHepatitis BHepatitis CSubstance useSyndemics

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