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Abstract Details
Distinct Hepatitis B and HIV co-infected populations in Canada
J Viral Hepat. 2020 Dec 11. doi: 10.1111/jvh.13453. Online ahead of print.
Curtis Cooper1, Matt Driedger1, David Wong2, Sarah Haylock-Jacobs3, Abdel Aziz Shaheen3, Carla Osiowy4, Scott Fung2, Karen Doucette5, Alexander Wong6, Lisa Barrett7, Brian Conway8, Alnoor Ramji9, Gerald Minuk, Giada Sebastiani, Philip Wong, Carla S Coffin3
Author information
1University of Ottawa.
2University of Toronto.
3University of Calgary.
4National Microbiology Laboratory.
5University of Alberta.
6University of Saskatchewan.
7Dalhousie University.
8Infectious Disease Centre, Vancouver.
9University of British-Columbia.
Abstract
Due to shared modes of exposure, HIV-HBV co-infection is common worldwide. Increased knowledge of the demographic and clinical characteristics of the co-infected population will allow us to optimize our approach to management of both infections in clinical practice. The Canadian Hepatitis B Network Cohort was utilized to conduct a cross-sectional evaluation of the demographic, biochemical, fibrotic and treatment characteristics of HIV-HBV patients and a comparator HBV group. From a total of 5996 HBV infected patients, 335 HIV-HBV patients were identified. HIV-HBV patients were characterized by older median age, higher male and lower Asian proportion, more advanced fibrosis, and higher anti-HBV therapy use (91% vs. 30%) than the HBV positive / HIV seronegative comparator group. A history of reported high-risk exposure activities (drug use, high-risk sexual contact) was more common in HIV-HBV patients. HIV-HBV patients with reported high-risk exposure activities had higher male proportion, more Caucasian ethnicity and higher prevalence of cirrhosis than HIV-HBV patients born in an endemic country. In the main cohort, age ≥60 yrs, male sex, elevated ALT, the presence of comorbidity and HCV seropositivity were independent predictors of significant fibrosis. HIV seropositivity was not an independent predictor of advanced fibrosis (adj OR 0.75 [95%CI: 0.34-1.67]). In conclusion, Canadian co-infected patients differed considerably from those with mono-infection. Furthermore, HIV-HBV infected patients who report high-risk behaviours and those born in endemic countries represent two distinct subpopulations, which should be considered when engaging these patients in care.