Human Immunodeficiency Virus (HIV) and Hepatitis Virus Coinfection among HIV-Infected Korean Patients: The Korea HIV/AIDS Cohort Study

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Abstract

Background

Despite declines in mortality and morbidity rates of patients with human immunodeficiency virus (HIV) infection as the result of highly active antiretroviral therapy, liver diseases due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a leading cause of death among HIV-infected patients. However, HIV and HBV or HCV coinfection is still poorly documented, and more information is needed to better understand the characteristics of HIV-infected patients in Korea.

Materials and Methods

A cross-sectional study was performed to investigate clinical characteristics and prevalence of HBV and HCV infection in HIV patients enrolled in the Korea HIV/acquired immune deficiency syndrome (AIDS) cohort study from 17 institutions between December 2006 and July 2013.

Results

Among the 1,218 HIV-infected participants, 541 were included in this study. The prevalence of HBV-HIV and HCV-HIV coinfection was 5.0% (27/541) and 1.7% (9/541), respectively. There was no patient who was positive for both HBs antigen and HCV antibody. In multivariate logistic regression analysis, HBV unvaccinated status was a significant risk factor for HBV-HIV coinfection (odds ratio = 4.95, 95% confidence interval = 1.43–17.13).

Conclusions

HBV and HCV infection was more common in HIV-infected persons enrolled in the Korean HIV/AIDS cohort, than in the general population in Korea.

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Most cited references 20

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Epidemiology of viral hepatitis and HIV co-infection.

Miriam J Alter (2006)

Worldwide, hepatitis B virus (HBV) accounts for an estimated 370 million chronic infections, hepatitis C virus (HCV) for an estimated 130 million, and HIV for an estimated 40 million. In HIV-infected persons, an estimated 2-4 million have chronic HBV co-infection and 4-5 million have HCV co-infection. HBV, HCV and HIV share common routes of transmission, but they differ in their prevalence by geographic region and the efficiency by which certain types of exposures transmit them. Among HIV-positive persons studied from Western Europe and the USA, chronic HBV infection has been found in 6-14% overall, including 4-6% of heterosexuals, 9-17% of men who have sex with men (MSM), and 7-10% of injection drug users. HCV infection has been found in 25-30% of HIV-positive persons overall; 72-95% of injection drug users, 1-12% of MSM and 9-27% of heterosexuals. The characteristics of HIV infected persons differ according to the co-infecting hepatitis virus, their epidemiologic patterns may change over time, and surveillance systems are needed to monitor their infection patterns in order to ensure that prevention measures are targeted appropriately.

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Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection.

I Bica, B McGovern, R. Dhar … (2001)

Highly active antiretroviral therapy has decreased human immunodeficiency virus (HIV)-associated mortality; other comorbidities, such as chronic liver disease, are assuming greater importance. We retrospectively examined the causes of death of HIV-seropositive patients at our institution in 1991, 1996, and 1998-1999. In 1998-1999, 11 (50%) of 22 deaths were due to end-stage liver disease, compared with 3 (11.5%) of 26 in 1991 and 5 (13.9%) of 36 in 1996 (P=.003). In 1998-1999, 55% of patients had nondetectable plasma HIV RNA levels and/or CD4 cell counts of >200 cells/mm(3) within the year before death. Most of the patients that were tested had detectable antibodies to hepatitis C virus (75% of patients who died in 1991, 57.7% who died in 1996, and 93.8% who died in 1998-1999; P=NS). In 1998-1999, 7 patients (31.8%) discontinued antiretroviral therapy because of hepatotoxicity, compared with 0 in 1991 and 2 (5.6%) in 1996. End-stage liver disease is now the leading cause of death in our hospitalized HIV-seropositive population.

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AIDS-defining opportunistic illnesses in US patients, 1994-2007: a cohort study.

Susan K. Wood, O. Baker, Richard Novak … (2010)

To assess the incidence and spectrum of AIDS-defining opportunistic illnesses in the highly active antiretroviral therapy (cART) era. A prospective cohort study of 8070 participants in the HIV Outpatient Study at 12 U.S. HIV clinics. We calculated incidence rates per 1000 person-years of observation for the first opportunistic infection, first opportunistic malignancy, and first occurrence of each individual opportunistic illness during 1994-2007. Using stratified Poisson regression models, and adjusting for sex, race, and HIV risk category, we modeled annual percentage changes in opportunistic illness incidence rates by calendar period. Eight thousand and seventy patients (baseline median age 38 years; median CD4 cell count 298 cells/microl) experienced 2027 incident opportunistic illnesses during a median of 2.9 years of observation. During 1994-1997, 1998-2002, and 2003-2007, respectively, rates of opportunistic infections (per 1000 person-years) were 89.0, 25.2 and 13.3 and rates of opportunistic malignancies were 23.4, 5.8 and 3.0 (P for trend <0.001 for both). Opportunistic illness rate decreases were similar for the subset of patients receiving cART. During 2003-2007, there were no significant changes in annual rates of opportunistic infections or opportunistic malignancies; the leading opportunistic illnesses (rate per 1000 person-years) were esophageal candidiasis (5.2), Pneumocystis pneumonia (3.9), cervical cancer (3.5), Mycobacterium avium complex infection (2.5), and cytomegalovirus disease (1.8); 36% opportunistic illness events occurred at CD4 cell counts at least 200 cells/microl. Opportunistic illness rates declined precipitously after introduction of cART and stabilized at low levels during 2003-2007. In this contemporary cART era, a third of opportunistic illnesses were diagnosed at CD4 cell counts at least 200 cells/microl.

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Author and article information

Journal

Journal ID (nlm-ta): Infect Chemother

Journal ID (iso-abbrev): Infect Chemother

Journal ID (publisher-id): IC

Title: Infection & Chemotherapy

Publisher: The Korean Society of Infectious Diseases and Korean Society for Chemotherapy

ISSN (Print): 2093-2340

ISSN (Electronic): 2092-6448

Publication date (Print): December 2017

Publication date (Electronic): 07 December 2017

Volume: 49

Issue: 4

Pages: 268-274

Affiliations

[1 ]Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

[2 ]Division of Infectious Disease, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

[3 ]Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

[4 ]Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.

[5 ]Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

[6 ]Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.

[7 ]Institute for Health and Society, Hanyang University, Seoul, Korea.

[8 ]Korea Centers for Disease Control and Prevention, Cheongju, Korea.

Author notes

Corresponding Author: Jun Yong Choi, MD, PhD. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-1974, Fax: +82-2-393-6884, seran@ 123456yuhs.ac

Author information

Yong Chan Kim https://orcid.org/0000-0003-4920-0399

Jun Yong Choi https://orcid.org/0000-0002-2775-3315

Article

DOI: 10.3947/ic.2017.49.4.268

PMC ID: 5754337

PubMed ID: 29299894

SO-VID: bc4013fc-a349-4f3d-a02f-55e068d82d00

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 01 June 2017

Date accepted : 27 September 2017

Funding

Funded by: Korea Centers for Disease Control and Prevention, CrossRef http://dx.doi.org/10.13039/501100003669;

Award ID: 4800-4859-304

Award ID: 2016-E51003-00

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Human Immunodeficiency Virus (HIV) and Hepatitis Virus Coinfection among HIV-Infected Korean Patients: The Korea HIV/AIDS Cohort Study

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Abstract

Background

Materials and Methods

Results

Conclusions

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Point-Of-Care Testing for Hepatitis

Most cited references 20

Epidemiology of viral hepatitis and HIV co-infection.

Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection.

AIDS-defining opportunistic illnesses in US patients, 1994-2007: a cohort study.

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