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A Spanish research team reports that
hepatitis B infection increases the risk of death by 75 percent for HIV/
hepatitis C-co-infected people. Earlier studies have focused on HIV/ hepatitis
C co-infection or HIV/hepatitis B co-infection, but not the consequences of
co-infection with all three viruses. Transmission is similar for HIV, hepatitis
B, and hepatitis C.
The study analyzed data from the
VACH cohort, comprised of 6,342 HIV/hepatitis C-infected individuals. Six
percent of the VACH cohort also had hepatitis B. Study participants who had all
three viruses were likely to be older, male, have a lower CD4 count, and higher
AST-to-platelet index than cohort members co-infected only with HIV and
hepatitis C.
VACH data provided almost 26,000
person-years of follow-up with a total of 543 deaths and an average mortality
rate of 2.1 per 100 person years. In contrast, co-infection with all three
viruses increased the mortality rate per 100 person years to 3.78. Researchers
initially concluded that co-infection with hepatitis B increased the mortality
rate by 90 percent, but they revised their estimate to 75 percent when they
factored in AIDS-defining illness, age, HIV and hepatitis C treatment, CD4 cell
count, and viral load. Factors that increased mortality risk for HIV/hepatitis
B/hepatitis C co-infected people included “detectable” viral load and older
age. Higher CD4 cell count, HIV treatment, and tenofovir treatment regimen
(effective against HIV, hepatitis B, and hepatitis C) comprised factors
associated with a better outcome.
The study also indicated that
HIV/hepatitis B/hepatitis C co-infection increases the risk of liver
disease-related death. Researchers strongly recommended hepatitis B
immunization for HIV-infected people and people at risk of HIV infection.
The full article, “Hepatitis B Virus
Infection Predicts Mortality of HIV and Hepatitis C Virus Co-infected Patients”
was published online in the journal AIDS 27 (2013;
doi:10.1097/QAD.0b013e32835ecaf7).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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