Wednesday, March 30, 2016

Chronic Hepatitis B Increases Mortality & Complexity among HIV-Coinfected Patients in South Africa

To assess the effect of chronic hepatitis B on survival and clinical complexity among people living with HIV following antiretroviral therapy (ART) initiation.

We evaluated mortality and single-drug substitutions up to 3 years from ART initiation (median follow-up 2.75 years; interquartile range 2-3 years) among patients with and without chronic hepatitis B (CHB) enrolled in a workplace HIV care programme in South Africa.

Mortality was increased for CHB patients with hepatitis B virus (HBV) DNA levels > 10 000 copies/mL (adjusted hazard ratio 3.1; 95% confidence interval 1.2-8.0) compared with non-CHB patients. We did not observe a similar difference between non-CHB patients and those with CHB and HBV DNA < 10 000 copies/mL (adjusted hazard ratio 0.70; 95% confidence interval 0.2-2.3). Single-drug substitutions occurred more frequently among coinfected patients regardless of HBV DNA level.

Our findings suggest that CHB may increase mortality and complicate ART management.

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  • 1The Aurum Institute, Johannesburg, South Africa.
  • 2School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
  • 3Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 
  •  2016 Mar 17. doi: 10.1111/hiv.12367.

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