Chronic hepatitis B increases mortality and complexity among HIV-coinfected patients in South Africa: A cohort study

K. Velen, S. Charalambous, C. Innes, G. J. Churchyard, Christopher Hoffmann

Research output: Contribution to journalArticle


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.

Original languageEnglish (US)
JournalHIV Medicine
Publication statusAccepted/In press - 2016



  • HIV
  • Africa
  • Antiretroviral therapy
  • Hepatitis B
  • Mortality

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Health Policy

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