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Chronic hepatitis B increases mortality and complexity among HIV ‐coinfected patients in South Africa: a cohort study
Author(s) -
Velen K,
Charalambous S,
Innes C,
Churchyard GJ,
Hoffmann CJ
Publication year - 2016
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12367
Subject(s) - medicine , interquartile range , hazard ratio , confidence interval , hepatitis b virus , hepatitis b , chronic hepatitis , cohort , cohort study , human immunodeficiency virus (hiv) , immunology , gastroenterology , virus
Objectives To assess the effect of chronic hepatitis B on survival and clinical complexity among people living with HIV following antiretroviral therapy (ART) initiation. Methods 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. Results 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. Conclusions Our findings suggest that CHB may increase mortality and complicate ART management.