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Mehershanhi S, Haider A, Kandhi S, Sun H, Patel H. Prevalence of Hepatocellular Carcinoma in HIV Patients Co-infected or Triple Infected With Hepatitis B and Hepatitis C in a Community Hospital in South Bronx. Cureus 2022; 14:e26089. [PMID: 35875299 PMCID: PMC9295826 DOI: 10.7759/cureus.26089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) share common modes of transmission; hence HBV and HCV infection are more prevalent among HIV patients. The co-infection with HIV/HBV, HIV/HCV, or HIV/HBV/HCV carries significant morbidity, with higher progression rates to end-stage liver disease or hepatocellular carcinoma (HCC). Methods We conducted a retrospective study among HIV adult patients co-infected with HBV or HCV and those with HCV, HIV, and HBV triple infection enrolled in the outpatient clinic of BronxCare Hospital between the years 2010 and 2021. Records were reviewed to obtain demographic data, including age and sex, hepatitis B surface antigen (HBsAg), anti-HCV antibodies, and CD4 T-lymphocyte count test results. Male and female patients ≥18 years with confirmed HIV by double enzyme-linked immunoassay (ELISA) and western blot, who underwent serology testing for both HBsAg and anti-HCV, were included in the study. Results In this study, 11355 HIV patients were included, comprising 7020 (61.8%) males and 4335 (38.2%) females. A total of 410 (3.6%) were hepatitis B positive, 1432 (12.6%) were hepatitis C positive, and 127 (1.1%) were both hepatitis B and C positive. Fifty-two (0.5%) patients were diagnosed with HCC. The majority of the patient with HCC (50%, n =26) were hepatitis C serology positive (p<0.001) while 9.6% (n=5) were positive for both hepatitis C and hepatitis B (p<0.001). Conclusion HIV/HBV/HCV triple-infected patients had a lower rate of HCC compared to HIV/HCV co-infected patients. HIV without hepatitis C or hepatitis B is an independent risk factor for HCC.
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Sun J, Althoff KN, Jing Y, Horberg MA, Buchacz K, Gill MJ, Justice AC, Rabkin CS, Goedert JJ, Sigel K, Cachay E, Park L, Lim JK, Kim HN, Lo Re V, Moore R, Sterling T, Peters MG, Achenbach CJ, Silverberg M, Thorne JE, Mayor AM, Crane HM, Kitahata MM, Klein M, Kirk GD. Trends in Hepatocellular Carcinoma Incidence and Risk Among Persons With HIV in the US and Canada, 1996-2015. JAMA Netw Open 2021; 4:e2037512. [PMID: 33595662 PMCID: PMC7890526 DOI: 10.1001/jamanetworkopen.2020.37512] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IMPORTANCE People with HIV (PWH) are often coinfected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV), leading to increased risk of developing hepatocellular carcinoma (HCC), but few cohort studies have had sufficient power to describe the trends of HCC incidence and risk among PWH in the combination antiretroviral therapy (cART) era. OBJECTIVE To determine the temporal trends of HCC incidence rates (IRs) and to compare rates by risk factors among PWH in the cART era. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) study, which was conducted between 1996 and 2015. NA-ACCORD pooled individual-level data from 22 HIV clinical and interval cohorts of PWH in the US and Canada. PWH aged 18 years or older with available CD4 cell counts and HIV RNA data were enrolled. Data analyses were completed in March 2020. EXPOSURES HBV infection was defined as detection of either HBV surface antigen, HBV e antigen, or HBV DNA in serum or plasma any time during observation. HCV infection was defined by detection of anti-HCV seropositivity, HCV RNA, or detectable genotype in serum or plasma at any time under observation. MAIN OUTCOMES AND MEASURES HCC diagnoses were identified on the basis of review of medical records or cancer registry linkage. RESULTS Of 109 283 PWH with 723 441 person-years of follow-up, the median (interquartile range) age at baseline was 43 (36-51) years, 93 017 (85.1%) were male, 44 752 (40.9%) were White, 44 322 (40.6%) were Black, 21 343 (19.5%) had HCV coinfection, 6348 (5.8%) had HBV coinfection, and 2082 (1.9%) had triple infection; 451 individuals received a diagnosis of HCC by 2015. Between the early (1996-2000) and modern (2006-2015) cART eras, the crude HCC IR increased from 0.28 to 0.75 case per 1000 person-years. HCC IRs remained constant among HIV-monoinfected persons or those coinfected with HBV, but from 1996 to 2015, IRs increased among PWH coinfected with HCV (from 0.34 cases/1000 person-years in 1996 to 2.39 cases/1000 person-years in 2015) or those with triple infection (from 0.65 cases/1000 person-years in 1996 to 4.49 cases/1000 person-years in 2015). Recent HIV RNA levels greater than or equal to 500 copies/mL (IR ratio, 1.8; 95% CI, 1.4-2.4) and CD4 cell counts less than or equal to 500 cells/μL (IR ratio, 1.3; 95% CI, 1.0-1.6) were associated with higher HCC risk in the modern cART era. People who injected drugs had higher HCC risk compared with men who had sex with men (IR ratio, 2.0; 95% CI, 1.3-2.9), adjusted for HBV-HCV coinfection. CONCLUSIONS AND RELEVANCE HCC rates among PWH increased significantly over time from 1996 to 2015. PWH coinfected with viral hepatitis, those with higher HIV RNA levels or lower CD4 cell counts, and those who inject drugs had higher HCC risk.
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Affiliation(s)
- Jing Sun
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Keri N. Althoff
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Yuezhou Jing
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Michael A. Horberg
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Kate Buchacz
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - M. John Gill
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amy C. Justice
- Department of Medicine, Yale University, West Haven, Connecticut
| | | | | | - Keith Sigel
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Edward Cachay
- Department of Medicine, University of California, San Diego, San Diego
| | - Lesley Park
- Center for Population Health Sciences, Stanford University School of Medicine, Stanford, California
| | - Joseph K. Lim
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - H. Nina Kim
- Department of Medicine, University of Washington, Seattle
| | - Vincent Lo Re
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia
- Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, Department of Medicine, University of Pennsylvania, Philadelphia
| | - Richard Moore
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Timothy Sterling
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Marion G. Peters
- Department of Medicine, University of California, San Francisco, San Francisco
| | - Chad J. Achenbach
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Angel M. Mayor
- Retrovirus Research Center, Department of Medicine, Universidad Central del Caribe School of Medicine, Bayamon, Puerto Rico
| | - Heidi M. Crane
- Department of Medicine, University of Washington School of Medicine, Seattle
| | - Mari M. Kitahata
- Department of Medicine, University of Washington School of Medicine, Seattle
| | - Marina Klein
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
| | - Gregory D. Kirk
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
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Dehghani-Dehej F, Hosseini Z, Mortazkar P, Khanaliha K, Esghaei M, Fakhim A, Bokharaei-Salim F. Prevalence of HCV and/or HBV coinfection in Iranian HIV-infected patients. Future Virol 2020. [PMCID: PMC7273902 DOI: 10.2217/fvl-2019-0066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aim: HIV-infected patients risk coinfection with HBV and HCV. This study aimed to investigate molecular epidemiology of HBV and HCV coinfection in Iranian HIV-infected individuals. Materials & methods: In this cross-sectional study, serological markers of HBV and HCV infection (hepatitis B surface antigen [HBsAg], hepatitis B e-antigen [HBeAg], hepatitis B e-antibody [HBeAb] and hepatitis B core antibody [HBcAb]) and anti-HCV antibodies [anti-HCV Abs] were tested in 198 Iranian HIV-infected patients. From plasma, HBV viral load was determined using COBAS TaqMan 48, and HCV-RNA was detected by reverse transcriptase-nested PCR. Results: 85 out of 198 (42.9%) patients were anti-HCV Ab positive and 42/198 (21.2%) had detectable HCV-RNA. Eight (4.0%) had traceable HBV-DNA. All these patients were infected by HBV genotype D. 55 (27.8%) were HBcAb positive. Nine (4.4%) were HBsAg and anti-HCV Ab positive. Conclusion: None were HIV-RNA/HCV-RNA/HBV-DNA positive, 21.2% were HIV-RNA/HCV-RNA positive and 4.0% were HIV-RNA/HBV-DNA positive. Therefore, studies on diagnosing these infections in HIV-infected individuals may be valuable.
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Affiliation(s)
- Farzaneh Dehghani-Dehej
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Master of Science of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Zinat Hosseini
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- General Medical Student, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Poupak Mortazkar
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- PhD Student of Virology, Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Khanaliha
- Research Center of Pediatric Infectious Diseases, Institute of Immunology & Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
- Assistant Professor of Parasitology, Research Center of Pediatric Infectious Diseases, Institute of Immunology & Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Esghaei
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Associate Professor of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Atousa Fakhim
- Department of Architectural Engineering, Faculty of Engineering, Islamic Azad University, South Tehran Branch, Tehran, Iran
- Student of Architectural Engineering, Islamic Azad University, South Tehran Branch, Tehran, Iran
| | - Farah Bokharaei-Salim
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Assistant Professor of Virology, Iran University of Medical Sciences, Tehran, Iran
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Coronel-Castillo CE, Qi X, Contreras-Carmona J, Ramírez-Pérez OL, Méndez-Sánchez N. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in HIV infection: a metabolic approach of an infectious disease. Expert Rev Gastroenterol Hepatol 2019; 13:531-540. [PMID: 30905208 DOI: 10.1080/17474124.2019.1599284] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
With the successes of antiretroviral therapy, patients infected with human immunodeficiency virus (HIV) living longer. Regarding this, the common diseases of HIV population (i.e., opportunistic infections) are now losing ground in front of metabolic alterations. This phenomenon is related to the delay in progression to acquired immune deficiency syndrome (AIDS), making it so that patients live in a chronic inflammatory state which, combined with other mechanisms such infectious ones, cause metabolic diseases. Areas covered: Considering a high prevalence of metabolic alterations, the relationship between metabolic syndrome (MetS) with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), and liver diseases as a major cause of death in the HIV-infected population, this paper aims to overview the mechanisms and prevalence of NAFLD and NASH as they relate to the developed metabolic diseases of HIV patients. Expert opinion: The pathways underlying MetS include the effects of HIV and ART on the liver, adipose tissue, and muscle. These mechanisms result in liver damage, consequently leading to NAFLD and its more severe form NASH. These conditions have increased in HIV-infected population in recent years and since their life expectancy is improving it is important to be ready to attend their new emerging diseases.
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Affiliation(s)
| | - Xingshun Qi
- b Department of Gastroenterology , General Hospital of Shenyang Military Area , Shenyang , China
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Wyles DL, Sulkowski MS, Dieterich D. Management of Hepatitis C/HIV Coinfection in the Era of Highly Effective Hepatitis C Virus Direct-Acting Antiviral Therapy. Clin Infect Dis 2017; 63 Suppl 1:S3-S11. [PMID: 27363438 DOI: 10.1093/cid/ciw219] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The increased life expectancy of persons infected with human immunodeficiency virus (HIV) treated with antiretroviral therapy (ART) has resulted in renewed attention to non-HIV-related diseases exacerbated by HIV infection. Coinfection with hepatitis C virus (HCV) is a particular area of concern, as the global prevalence has been estimated at 2.5-5 million people. In this article, we discuss the epidemiology of HCV infection and reinfection, HCV-related liver disease progression in the era of effective ART, and the efficacy of emerging HCV treatment strategies in persons with HIV/HCV coinfection. New data regarding treatment of persons with HIV/HCV coinfection suggest that HCV treatment should be a priority in those with HIV. Results from recent studies using all-oral HCV regimens have shown high rates of sustained virologic response in both clinical trials and real-world settings. A multidisciplinary approach to HCV treatment in those with HIV is recommended for optimal patient management. Following HCV cure, practitioners also need to be mindful of the risks for HCV reinfection and educate patients on protective measures.
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Affiliation(s)
- David L Wyles
- Divisions of Infectious Diseases, Department of Medicine, University of California, San Diego
| | - Mark S Sulkowski
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Douglas Dieterich
- Division of Liver Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Sherman KE, Peters MG, Thomas D. Human immunodeficiency virus and liver disease: A comprehensive update. Hepatol Commun 2017; 1:987-1001. [PMID: 30838978 PMCID: PMC5721407 DOI: 10.1002/hep4.1112] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/29/2017] [Accepted: 09/19/2017] [Indexed: 12/16/2022] Open
Abstract
Among persons living with human immunodeficiency virus (HIV) infection, liver disease remains a major cause of morbidity and mortality. While the etiologies are varied and often overlapping in the individual patient, the underlying mechanisms, including oxidative stress, direct activation of stellate cells, HIV interaction with hepatocytes, and bacterial translocation with systemic immune activation, seem to be unifying characteristics. Early and fully suppressive HIV antiretroviral therapy is a mainstay of management either before or concurrent with treatment of etiologic cofactors, including hepatitis C virus, hepatitis B virus, and nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Significant barriers to care that still exist include liver disease recognition, appropriate linkage to care, ongoing substance abuse, and psychiatric comorbidities in the HIV-infected population. Emerging issues in these patients include acute and chronic hepatitis E, underreported hepatitis D, and a rising incidence of hepatocellular carcinoma. (Hepatology Communications 2017;1:987-1001).
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Chronic Hepatitis B, C, and D. Microbiol Spectr 2017; 4. [PMID: 27726758 DOI: 10.1128/microbiolspec.dmih2-0025-2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chronic hepatitis B, C, and D virus infections contribute significantly to the morbidity and mortality of immunocompromised individuals. To contextualize discussion of these infections in immunocompromised patients, this paper provides an overview of aspects of infection in normal hosts. It then describes differences in disease, diagnostic testing, and therapeutic management observed in immunocompromised patients.
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Klein MB, Althoff KN, Jing Y, Lau B, Kitahata M, Lo Re V, Kirk GD, Hull M, Kim HN, Sebastiani G, Moodie EEM, Silverberg MJ, Sterling TR, Thorne JE, Cescon A, Napravnik S, Eron J, Gill MJ, Justice A, Peters MG, Goedert JJ, Mayor A, Thio CL, Cachay ER, Moore R. Risk of End-Stage Liver Disease in HIV-Viral Hepatitis Coinfected Persons in North America From the Early to Modern Antiretroviral Therapy Eras. Clin Infect Dis 2016; 63:1160-1167. [PMID: 27506682 PMCID: PMC5064164 DOI: 10.1093/cid/ciw531] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/30/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-infected patients coinfected with hepatitis B (HBV) and C (HCV) viruses are at increased risk of end-stage liver disease (ESLD). Whether modern antiretroviral therapy has reduced ESLD risk is unknown. METHODS Twelve clinical cohorts in the United States and Canada participating in the North American AIDS Cohort Collaboration on Research and Design validated ESLD events from 1996 to 2010. ESLD incidence rates and rate ratios according to hepatitis status adjusted for age, sex, race, cohort, time-updated CD4 cell count and HIV RNA were estimated in calendar periods corresponding to major changes in antiretroviral therapy: early (1996-2000), middle (2001-2005), and modern (2006-2010) eras. RESULTS Among 34 119 HIV-infected adults followed for 129 818 person-years, 380 incident ESLD outcomes occurred. ESLD incidence (per 1000 person-years) was highest in triply infected (11.57) followed by HBV- (8.72) and HCV- (6.10) coinfected vs 1.27 in HIV-monoinfected patients. Adjusted incidence rate ratios (95% confidence intervals) comparing the modern to the early antiretroviral era were 0.95 (.61-1.47) for HCV, 0.95 (.40-2.26) for HBV, and 1.52 (.46-5.02) for triply infected patients. Use of antiretrovirals dually activity against HBV increased over time. However, in the modern era, 35% of HBV-coinfected patients were not receiving tenofovir. There was little use of HCV therapy. CONCLUSIONS Despite increasing use of antiretrovirals, no clear reduction in ESLD risk was observed over 15 years. Treatment with direct-acting antivirals for HCV and wider use of tenofovir-based regimens for HBV should be prioritized for coinfected patients.
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Affiliation(s)
- Marina B Klein
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Bryan Lau
- Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - Mark Hull
- British Columbia Centre for Excellence in HIV/AIDS and University of British Columbia, Vancouver, Canada
| | | | | | | | | | | | | | - Angela Cescon
- Northern Ontario School of Medicine, Sudbury, Canada
| | | | - Joe Eron
- University of North Carolina, Chapel Hill
| | | | - Amy Justice
- Yale University and the Veterans Affairs Connecticut Healthcare System, New Haven
| | | | - James J Goedert
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Angel Mayor
- Retrovirus Research Center, Universidad Central del Caribe, Bayamon, Puerto Rico
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Wittkop L. Editorial Commentary: End-Stage Liver Disease in HIV Infection: An Avoidable Burden? Clin Infect Dis 2016; 63:1168-1170. [PMID: 27506684 DOI: 10.1093/cid/ciw537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 12/21/2022] Open
Affiliation(s)
- Linda Wittkop
- University of Bordeaux Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique d'Epidémiologie et de Développement, Centre INSERM U1219- Bordeaux Population Health Centre Hospitalier Universitaire de Bordeaux, Pole de sante publique, Service d'information medicale, France
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Al-Mughales JA. Co-infection assessment in HBV, HCV, and HIV patients in Western Saudi Arabia. J Med Virol 2016; 88:1545-51. [PMID: 26895691 DOI: 10.1002/jmv.24503] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 12/11/2022]
Abstract
To estimate the prevalence of diagnosed and undiagnosed coinfections among HIV, HBV, and HCV infected patients. Retrospective analysis of laboratory records for HIV, HBV, and HCV patients presenting at the HIV outpatient clinic. Serological data including hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg), hepatitis B e-antibody (anti-HBe), antibodies to HIV and HCV, anti-toxoplasmosis IgG and IgM antibodies, and anti-syphilis antibodies (VDRL) were collected. We obtained data for 628 (218 HCV, 268 HBV, and 142 HIV) patients. Male-to-female ratios were 1:1 for HCV, 3:4 for HBV, and 5:3 for HIV. Age means (SD) were 54.24 (16.40), 44.53 (18.83), and 40.39 (15.92) years for HCV, HBV, and HIV, respectively. In HIV group, the prevalence of HBV and HCV coinfections was 8.5% and 2.8%, respectively. In HBV group, the prevalence of HCV and HIV coinfections was 1.1% and 1.5%, respectively. In HCV group, HIV or HBV coinfections occurred at the same frequency (1.4%). An absence of screening for coinfections was detected in 7.0-48.5% patients as per the group and the infectious agent; which represents an estimated proportion of 20 out of 1,000 patients with an undiagnosed coinfection. Despite a relatively low prevalence of coinfections, a significant proportion of cases remain undiagnosed because of a lack of systematic screening. J. Med. Virol. 88:1545-1551, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jamil A Al-Mughales
- Division of Diagnostic Immunology, Department of Clinical Laboratory Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.,Faculty of Medicine, Department of Medical Microbiology and Immunology, King Abdulaziz University, Jeddah, Saudi Arabia
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Utsumi T, Lusida MI. Viral hepatitis and human immunodeficiency virus co-infections in Asia. World J Virol 2015; 4:96-104. [PMID: 25964874 PMCID: PMC4419124 DOI: 10.5501/wjv.v4.i2.96] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/05/2015] [Accepted: 02/04/2015] [Indexed: 02/05/2023] Open
Abstract
Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) affect many people in Asian countries, although there are geographic differences. Both HBV and HIV (HBV/HIV) and HCV/HIV co-infections are highly prevalent in Asia. Hetero- and homosexual, injection drug use, and geographic area are strong predictors of HBV, HCV, and HIV serostatus. In HBV endemic regions, the prevalence and genotype distribution of HBV/HIV co-infection is almost comparable with that in the general population. In Japan, where HBV has low endemicity, the prevalence of HBV/HIV co-infection is approximately 10-fold higher than that in the general population, and HBV Ae is the most common subgenotype among HIV infected individuals. Highly active antiretroviral therapy (HAART) is an effective treatment for HIV/Acquired Immune Deficiency Syndrome. Lamivudine, a component of HAART, is an effective treatment for HBV, HIV, and HBV/HIV co-infection; however, cost, emerging drug resistance, antiretroviral-associated liver toxicity and liver-related morbidity due to HCV progression are particular concerns. HCV/HIV co-infection may accelerate the clinical progression of both HCV and HIV. The high prevalence of HBV/HIV and HCV/HIV co-infections in Asia underscores the need to improve prevention and control measures, as fewer evidence-based prevention strategies are available (compared with Western countries). In this review, the most recent publications on the prevalence of HBV/HIV and HCV/HIV co-infections and related issues, such as therapy and problems in Asia, are updated and summarized.
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