학술논문
Determinants of Liver Complications Among HIV/Hepatitis B Virus-Coinfected Patients.
Document Type
article
Author
Lo Re, Vincent; Newcomb, Craig W; Carbonari, Dena M; Roy, Jason A; Althoff, Keri N; Kitahata, Mari M; Reddy, K Rajender; Lim, Joseph K; Silverberg, Michael J; Mayor, Angel M; Horberg, Michael A; Cachay, Edward R; Kirk, Gregory D; Hull, Mark; Gill, John; Sterling, Timothy R; Kostman, Jay R; Peters, Marion G; Moore, Richard D; Klein, Marina B; Kim, H Nina
Source
JAIDS Journal of Acquired Immune Deficiency Syndromes. 82(1)
Subject
Language
Abstract
BackgroundHepatitis B virus (HBV) infection is a leading cause of end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) in HIV. Factors contributing to the high rates of liver complications among HIV/HBV-coinfected individuals remain unknown.SettingNorth American AIDS Cohort Collaboration on Research and Design.MethodsWe performed a retrospective cohort study among HIV/HBV-coinfected patients in 10 US and Canadian cohorts of the North American AIDS Cohort Collaboration on Research and Design that validated ESLD (ascites, spontaneous bacterial peritonitis, variceal hemorrhage, and/or hepatic encephalopathy) and HCC diagnoses from 1996 to 2010. Multivariable Cox regression was used to examine adjusted hazard ratios [aHRs with 95% confidence interval (CIs)] of liver complications (first occurrence of ESLD or HCC) associated with hypothesized determinants and with increasing durations of HIV suppression (≤500 copies/mL).ResultsAmong 3573 HIV/HBV patients with 13,790 person-years of follow-up, 111 liver complications occurred (incidence rate = 8.0 [95% CI: 6.6 to 9.7] events/1000 person-years). Rates of liver complication were increased with non-black/non-Hispanic race [aHR = 1.76 (1.13-2.74)], diabetes mellitus [aHR = 2.07 (1.20-3.57)], lower time-updated CD4 cell count [3.25: aHR = 9.79 (5.73-16.74); 1.45-3.25: aHR = 3.20 (1.87-5.47) versus FIB-4