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Distinct Hepatitis B and HIV co-infected populations in Canada

Curtis Cooper1, Matt Driedger1, David Wong2

  • 1University of Ottawa, Ottawa, Ontario, Canada.

Journal of Viral Hepatitis
|December 11, 2020
PubMed

Insights

HIV-HBV co-infection is common. Canadian HIV-HBV patients are older, more male, have advanced fibrosis, and higher treatment use than HBV-only patients. Risk behaviors and origin define distinct HIV-HBV subgroups.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Clinical Epidemiology

Background:

  • Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) co-infection presents unique clinical challenges due to shared transmission routes.
  • Understanding the characteristics of co-infected individuals is crucial for refining clinical management strategies.
  • The Canadian Hepatitis B Network Cohort provides a valuable dataset for evaluating HIV-HBV co-infection.

Purpose of the Study:

  • To compare the demographic, biochemical, fibrotic, and treatment profiles of patients with HIV-HBV co-infection versus HBV mono-infection.
  • To identify factors associated with advanced fibrosis in the co-infected population.
  • To delineate distinct subpopulations within the HIV-HBV co-infected group.

Main Methods:

  • A cross-sectional analysis of the Canadian Hepatitis B Network Cohort.
  • Inclusion of 5996 HBV-infected patients, with 335 identified as HIV-HBV co-infected.
  • Comparison of demographic, clinical, and treatment data between HIV-HBV and HBV-only groups, and subgroup analysis based on risk exposure and country of origin.

Main Results:

  • HIV-HBV patients were older, had a higher male proportion, lower Asian representation, more advanced fibrosis, and greater anti-HBV therapy use (91% vs. 30%) compared to HBV-only patients.
  • High-risk exposure activities were more prevalent in HIV-HBV patients.
  • HIV-HBV patients reporting high-risk behaviors differed from those born in endemic countries regarding ethnicity and cirrhosis prevalence. Age ≥60, male sex, elevated ALT, comorbidities, and HCV co-infection predicted fibrosis, but HIV status did not independently predict advanced fibrosis.

Conclusions:

  • Canadian patients with HIV-HBV co-infection exhibit distinct characteristics compared to those with HBV mono-infection.
  • HIV-HBV patients reporting high-risk behaviors and those originating from endemic countries represent two clinically relevant, distinct subpopulations.
  • These findings necessitate tailored approaches for managing HIV-HBV co-infected individuals based on their specific risk factors and origins.

Keywords:
Hepatitis BNorth Americaepidemiologyhuman Immunodeficiency Virusliver disease

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