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, C. J. Hoffmann

Research output: Contribution to journalArticlepeer-review

Abstract

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)
Pages (from-to)702-707
Number of pages6
JournalHIV Medicine
Volume17
Issue number9
DOIs
StatePublished - Jan 1 2016

Keywords

  • Africa
  • HIV
  • antiretroviral therapy
  • hepatitis B
  • mortality

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

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