• 1 Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
  • 2 Department of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Taiwan
  • 3 The Kirby Institute, UNSW Australia, Sydney, Australia
  • 4 Division of Infectious Diseases, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 5 Working Group on AIDS Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • 6 Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia
  • 7 Tan Tock Seng Hospital, Singapore, Singapore
  • 8 Research Institute for Health Sciences, Chiang Mai, Thailand
  • 9 HIV-NAT/ Thai Red Cross AIDS Research Centre, Bangkok, Thailand
  • 10 Queen Elizabeth Hospital, Hong Kong, China
  • 11 Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India
  • 12 National Center for HIV/AIDS, Dermatology & STDs, and University of Health Sciences, Phnom Penh, Cambodia
  • 13 Research Institute for Tropical Medicine, Manila, Philippines
  • 14 Hospital Sungai Buloh, Sungai Buloh, Malaysia
  • 15 National Hospital for Tropical Diseases, Hanoi, Vietnam
  • 16 Institute of Infectious Diseases, Pune, India
  • 17 University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 18 Beijing Ditan Hospital, Capital Medical University, Beijing, China
  • 19 Bach Mai Hospital, Hanoi, Vietnam
  • 20 Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
  • 21 National Center for Global Health and Medicine, Tokyo, Japan
  • 22 Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 23 Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia
  • 24 Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 25 TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand
PLoS ONE, 2016;11(3):e0150512.
PMID: 26933963 DOI: 10.1371/journal.pone.0150512


BACKGROUND: We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region.

METHODS: Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test.

RESULTS: A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive.

CONCLUSION: In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.