Hepatitis B and C in HIV-infected patients. Prevalence and prognostic value.
OBJECTIVE
There is only limited information on the prevalence and influence of coinfection with either hepatitis B or C on the clinical course in patients infected with the human immunodeficiency virus (HIV).


METHODS
Follow-up was available in 232 HIV-infected patients (age 37+/-8 years, CD4 count 167+/-167 microl; 46% had AIDS). Samples were investigated for markers of HBV and HCV infection (HBsAg, HBeAg, HBV-DNA, Anti-HBs, anti-HBc, anti-HCV, HCV-RNA).


RESULTS
60/232 patients (23%) were anti-HCV positive. 78% of these sera were positive for HCV-RNA. 22/232 patients (9%) suffered from chronic HBV infection (HBsAg positive), 18/22 (82%) of these sera had detectable HBeAg and 19/22 (86%) HBV-DNA. Presence of HCV-RNA, HBeAg and amount of HBV-DNA were related to the degree of immunodeficiency. In contrast to the control group without HBV or HCV infection, patients infected with HIV and either HBV or HCV showed a direct correlation between a reduction in CD4 counts and decreased cholinesterase activity. In patients with AIDS, coinfection with HBV or HCV was associated with a reduced survival compared to controls (HBV: 212 days, 95%CI, 106-317; HCV: 267, 95%CI, 112-396; controls: 439 days, 95%CI, 364-513).


CONCLUSIONS
Coinfection of HIV and HBV or HCV is frequently observed. Our results suggest that with prolonged survival of HIV-infected patients, coinfection with either HBV or HCV correlates with a reduced survival rate.
Ockenga
J
J
Department of Clinical Immunology, Hannover Medical School, Germany.
Tillmann
H L
HL
Trautwein
C
C
Stoll
M
M
Manns
M P
MP
Schmidt
R E
RE
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D008297:Male; D015995:Prevalence; D011379:Prognosis; D015996:Survival Rate