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(Suppl 1):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.