The role of HIV/hepatitis B virus/hepatitis C virus RNA+ triple infection in end-stage liver disease and all-cause mortality in Europe. (1st January 2023)

• Record Type: Journal Article
• Authors: Mocroft, Amanda; Geressu, Adam; Beguelin, Charles; Llibre, Josep M.; Lazarus, Jeffrey V.; Tomazic, Janez; Smidt, Jelena; Parczewski, Milosz; Brännström, Johanna; Sedlacek, Dalibor; Degen, Olaf; van der Valk, Marc; Paduta, Dzmitry; Flamholc, Leo; Schmid, Patrick; Orkin, Chloe; Nielsen, Lars N.; Hoffmann, Christian; Beniowski, Marek; Oprea, Cristiana; Begovac, Josip; Peters, Lars
• Is Part Of: AIDS. Volume 37:Number 1(2023)
• Page Start: 91
• Page End: 103
• Publication Date: 2023-01-01
• Subjects: hepatitis B -- hepatitis C -- HCVRNA -- end stage liver disease -- all-cause mortality; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000003406
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Background: There are limited data on end-stage liver disease (ESLD) and mortality in people with HIV (PWH) coinfected with both hepatitis B virus (HBV) and hepatitis C virus (HCV). Methods: All PWH aged greater than 18 under follow-up in EuroSIDA positive for HBsAg (HBV), and/or HCVRNA+, were followed from baseline (latest of 1 January 2001, EuroSIDA recruitment, known HBV/HCV status) to ESLD, death, last visit, or 31 December 2020. Follow-up while HCVRNA- was excluded. In two separate models, Poisson regression compared three groups updated over time; HIV/HBV, HIV/HCV, and HIV/HBV/HCV. Results: Among 5733 included individuals, 4476 (78.1%) had HIV/HCV, 953 (16.6%) had HIV/HBV and 304 (5.3%) had HIV/HBV/HCV. In total, 289 (5%) developed ESLD during 34 178 person-years of follow-up (PYFU), incidence 8.5/1000 PYFU [95% confidence interval (CI) 7.5–9.4] and 707 deaths occurred during 34671 PYFU (incidence 20.4/1000 PYFU; 95% CI 18.9–21.9). After adjustment, compared with those with HIV/HCV, persons with HIV/HBV had significantly lower rates of ESLD [adjusted incidence rate ratio (aIRR) 0.53; 95% CI 0.34–0.81]. Those with HIV/HBV/HCV had marginally significantly higher rates of ESLD (aIRR 1.49; 95% CI 0.98–2.26). Those under follow-up in 2014 or later had significantly lower rates of ESLD compared with 2007–2013 (aIRR 0.65; 95% CI 0.47–0.89). Differences in ESLD between the three groups were most pronounced in those aged at least 40. After adjustment, there were no significant differences in all-cause mortality across the three groups. Conclusion: HIV/HBV-coinfected individuals had lower rates of ESLD and HIV/HBV/HCV had higher rates of ESLD compared with those with HIV/HCV, especially in those aged more than 40. ESLD decreased over time across all groups. ClinicalTrials.gov Identifier: NCT02699736.