Treatment outcomes of HIV patients with hepatitis B and C virus co-infections in Southwest China:an observational cohort study  

作　　者：Jingya Jia Qiuying Zhu Luojia Deng Guanghua Lan Andrew Johnson Huanhuan Chen Zhiyong Shen Jianjun Li Hui Xing Yuhua Ruan Jing Li Hui Lu Sten H.Vermund Jinhui Zhu Han-Zhu Qian 

机构地区：[1]SJTU-Yale Joint Center for Biostatistics and Data Science,Shanghai Jiao Tong University,Shanghai,China [2]Department of Bioinformatics and Biostatistics,School of Life Sciences and Biotechnology,Shanghai Jiao Tong University,Shanghai,China [3]Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response,Guangxi Center for Disease Control and Prevention,Nanning,China [4]Groton School,Groton,MA,USA [5]State Key Laboratory of Infectious Disease Prevention and Control(SKLID),Chinese Center for Disease Control and Prevention(China CDC),Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,Beijing,China [6]School of Public Health,Yale University,New Haven,CT,USA

出　　处：《Infectious Diseases of Poverty》2022年第1期27-33,共7页贫困所致传染病（英文）

基　　金：This work was supported by National Natural Science Foundation of China[82160636,11971479,31871329];Guangxi Natural Science Foundation Project(Grants 2020GXNSFAA159020);Guangxi Key Laboratory of AIDS Prevention Control and Translation[ZZH2020010];Guangxi Bagui Honor Scholarship,and Chinese State Key Laboratory of Infectious Disease Prevention and Control.

摘　　要：Background:Antiretroviral therapy(ART)has reduced mortality among people living with HIV(PLWH)in China,but co-infections of hepatitis B virus(HBV)and hepatitis C virus(HCV)may individually or jointly reduce the effect of ART.This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART.Methods:A retrospective cohort study analysis of 58,239 people living with HIV(PLWH)who initiated antiretroviral therapy(ART)during 2010-2018 was conducted in Guangxi Province,China.Data were from the observational database of the National Free Antiretroviral Treatment Program.Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH.Results:Our study showed high prevalence of HBV(11.5%),HCV(6.6%)and HBV-HCV(1.5%)co-infections.The overall mortality rate and treatment attrition rate was 2.95[95%confidence interval(CI):2.88-3.02]and 5.92(95%CI:5.82-6.01)per 100 person-years,respectively.Compared with HIV-only patients,HBV-co-infected patients had 42%higher mortality[adjusted hazard ratio(a HR)=1.42;95%CI 1.32-1.54],HCV-co-infected patients had 65%higher mortality(a HR=1.65;95%CI:1.47-1.86),and patients with both HCV and HBV co-infections had 123%higher mortality(a HR=2.23;95%CI:1.87-2.66).Conclusions:HBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART.It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH.

关 键 词：HEPATITIS C VIRUS HEPATITIS B VIRUS HIV ANTIRETROVIRAL therapy Mortality Retrospective cohort 

分 类 号：R512.6[医药卫生—内科学] R512.91[医药卫生—临床医学]