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

July 6, 2011

Infection

DOI: 10.1007/s15010-011-0145-1Online First¢â

Clinical and Epidemiological Study

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

coinfected Han Chinese

R. Yang, X. Gui, Y. Xiong, S. Gao, Y. Zhang, L. Deng, K. Liang, Y. Yan and Y.

Rong

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/mm3 (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

¡Ã150 cells/mm3 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.

July 6, 2011