HIV co-infection is associated with increased liver complications and reduced mental health among patients with chronic hepatitis B.
Lu M, Markowitz NP, Zhou Y, Wu KH, Rupp LB, Trudeau S, Li J, Boscarino JA, Schmidt MA, Daida YG, and Gordon SC. HIV co-infection is associated with increased liver complications and reduced mental health among patients with chronic hepatitis B. J Hepatol 2018; 68:S152-S153.
Background and Aims: Most studies of hepatitis B (HBV) and HIV coinfection focus on HIV cohorts, and thus may not collect data regarding HBV-related treatment or outcomes.We used data from the Chronic Hepatitis Cohort Study (CHeCS)-a racially- and geographically- diverse sample from four large US health systems-to investigate the impact of HIV on the clinical characteristics and mental health of patients with chronic hepatitis B. Method: Patient demographics and clinical status were collected from the electronic health record from date of diagnosis (HBV or HIV/ HBV co-infection) onward. A subgroup provided survey data regarding health-related behaviors and mental health. Chi-square tests and two-sample t-tests were used to compare categorical and continuous variables, respectively, between HBV mono-infected and HIV/HBV coinfected patients. Results: Among a sample of 4640 HBV patients, 300 (6.5%) were HIV co-infected. HIV/HBV co-infected patients were significantly more likely to be male, African American or white, low-income, and publicly insured than HBV mono-infected patients. Despite high rates of antiviral treatment, co-infected patients also demonstrated increased comorbidities, fibrosis/ cirrhosis, and mortality. Among a subgroup of 980 survey respondents (913 HBV, 67 HIV/HBV), coinfected patients were significantly more likely to be depressed, to have lower mental health scores, and to report being “highly stressed”. Conclusion: HIV co-infection impacts a demographically distinct subset of HBV patients. Despite high rates of antiviral treatment, coinfected patients demonstrate increased rates of liver-related complications and report poor mental health outcomes.