HIV
and Hepatitis.com Coverage of the 14th
Annual Conference on Retroviruses and Opportunistic Infections (14th CROI) February
25 - 28, 2007, Los Angeles, CA
HBV Less Likely than HCV to Cause Liver Disease Progression and Death in People
with HIV
In
the first study, researchers analyzed all HIV positive patients coinfected with
HBV (positive for HBV surface antigen) or HCV (detectable HCV antibodies or HCV
RNA) in the Netherlands ATHENA observational HIV cohort. Data on liver disease
were systematically collected from January 2001 onward.
Results
•
Of
12257 HIV-infected patients in the cohort, 1129 (9%) were HCV coinfected and 815
(7%) were HBV coinfected.
•
31 patients (0.3%)
triply infected with HIV, HBV, and HCV were excluded from the analysis.
•
246 coinfected patients
(13%) died during follow-up.
•
The
risk of liver disease was nearly twice as high in HCV-HIV coinfected patients
compared with HBV-HIV coinfected individuals
(adjusted risk ratio 1.93).
•
Time to death did not
differ between patients with and without HBV.
The
researchers concluded that, "HCV coinfected HAART-treated patients have a
faster progression to hepatitis-related liver disease and to death than HBV-HIV
coinfected patients, suggesting that progression to liver-related disease may
be faster in HCV coinfected patients."
HIV Monitoring Fndn, Academic
Med Ctr, Univ of Amsterdam, Netherlands; Ctr for Immunity and Infection, Academic
Med Ctr, Univ of Amsterdam, Netherlands; Imperial Coll Sch of Med, London, UK.
In
the second study, researchers in Texas analyzed serum samples from 129 coinfected
patients seen at an inner city HIV clinic; about half had both baseline and follow-up
samples.
•
45
patients had HIV-HBV coinfection, 43 had HIV-HCV confection, and 41 had HIV-HBV-HCV
triple infection.
•
Triply infected patients
had significantly lower HBV viral loads compared with HIV-HBV coinfected patients.
•
The
triply infected group was more likely to also have hepatitis delta virus (HDV).
•
Triply
infected patients were more likely to have cirrhosis (31%) than those with HIV-HBV
coinfection (9%) or HIV-HCV coinfection (10%).
•
A higher proportion
of deaths were seen in HIV-HCV coinfected patients (33%) compared with HIV-HBV
coinfected (20%) and triply infected (23%) patients.
"The
presence of HCV in those with triple infection appears to diminish HBV DNA levels
as compared with the HIV/HBV setting but the reverse is not true," the researchers
concluded. "Triply infected persons appear to have more severe disease and
are more likely to have delta virus, possibly due to injection drug use and should
be evaluated for these features." Univ of Texas Southwestern Med
Ctr, Dallas, TX.
C
Smit, L Gras, A van Sighem, and others. Increased Progression to Liver Disease
and Death in HIV/HCV than in HBV-co-infected Patients. 14th Conference on Retroviruses
and Opportunistic Infections; February 25-28, 2007; Los Angeles, California. Abstract
932 (poster).
M
Jain, R Joshi, N Attar, and others. Comparison of Triple Infection with HIV/HBV/HCV
to HIV/HCV and HIV/HBV. 14th Conference on Retroviruses and Opportunistic Infections;
February 25-28, 2007; Los Angeles, California. Abstract 933 (poster).
