UBC Faculty Research and Publications

Characteristics and outcomes of antiretroviral-treated HIV-HBV co-infected patients in Canada? Rana, Urvi; Driedger, Matt; Sereda, Paul; Pan, Shenyi; Ding, Erin; Wong, Alex; Walmsley, Sharon; Klein, Marina; Kelly, Deborah; Loutfy, Mona; Thomas, Rejean; Sanche, Stephen; Kroch, Abigail; Machouf, Nima; Roy-Gagnon, Marie-Helene; Hogg, Robert; Cooper, Curtis L

Abstract

Abstract Background Hepatitis B (HBV) and Human Immunodeficiency Virus (HIV) share common risk factors for exposure. Co-infected patients have an increased liver-related mortality risk and may have accelerated HIV progression. The epidemiology and demographic characteristics of HIV-HBV co-infection in Canada remain poorly defined. We compared the demographic and clinical characteristics and factors associated with advanced hepatic fibrosis between HIV and HIV-HBV co-infected patients. Methods A retrospective cohort analysis was conducted using data from the Canadian Observational Cohort (CANOC) Collaboration, including eight sites from British Columbia, Quebec, and Ontario. Eligible participants were HIV-infected patients who initiated combination ARV between January 1, 2000 and December 14, 2014. Demographic and clinical characteristics were compared between HIV-HBV co-infected and HIV-infected groups using chi-square or Fisher exact tests for categorical variables, and Wilcoxon’s Rank Sum test for continuous variables. Liver fibrosis was estimated by the AST to Platelet Ratio Index (APRI). Results HBV status and APRI values were available for 2419 cohort participants. 199 (8%) were HBV co-infected. Compared to HIV-infected participants, HIV-HBV co-infected participants were more likely to use injection drugs (28% vs. 21%, p = 0.03) and be HCV-positive (31%, vs. 23%, p = 0.02). HIV-HBV co-infected participants had lower baseline CD4 T cell counts (188 cells/mm₃, IQR: 120–360) compared to 235 cells/mm₃ in HIV-infected participants (IQR: 85–294) (p = 0.0002) and higher baseline median APRI scores (0.50 vs. 0.37, p 

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