Risk of liver-associated morbidity and mortality in a cohort of HIV and HBV coinfected Han Chinese.

OBJECTIVES

To investigate the incidence and risk factors of liver-associated morbidity and mortality in Han Chinese patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection.

METHODS

A retrospective study was conducted.

RESULTS

Of the 255 subjects with HIV and HBV coinfection, 181 (71.0%) received lamivudine-based combined antiretroviral therapy (cART). Of the patients, 49/255 (19.2%) developed advanced liver diseases (ALDs) (during 5.2 years): 30 patients developed clinically overt cirrhosis, 10 developed hepatocellular carcinoma and 9 developed severe reactivation of a preexisting chronic hepatitis B. Baseline CD4(+) cell count <200 cell/mm(3) (P = 0.013, OR = 6.503), baseline alanine aminotransferase (ALT) elevation (P = 0.011, OR = 14.456), and longer cumulated time with detectable HIV RNA (P = 0.008, OR = 1.814) and HBV DNA (P = 0.014, OR = 1.536) were risk factors for ALDs development, while CD4(+) cell count changes ≥150 cells/mm(3) within 3 months (P = 0.039, OR = 0.049) and the use of lamivudine-based cART (P = 0.030, OR = 0.034) were protective against ALDs development.

CONCLUSIONS

ALDs was common among HIV and HBV coinfected Han Chinese patients. Lamivudine-based cART was beneficial in terms of sustained HBV viral suppression and resulted in less incidence of ALDs.