title: Correlates of poor perceived health among individuals living with HIV and HBV chronic infections: a longitudinal assessment.
abstract: Chronic hepatitis B virus (HBV) infection affects up to 14% of people living with HIV and AIDS (PLWHA) and is associated with a higher risk of non-AIDS death. While great advances have been made in the therapeutic management of co-infection with HIV and HBV, nothing is known about perceived health in people living with HIV and HBV. This study aimed at characterizing individuals with poor perceived overall health among 308 HIV-HBV co-infected individuals enrolled between May 2002 and May 2003 in a three-year French cohort. A binary score for perceived overall health (good vs. poor) was calculated from individuals' responses to the COOP-WONCA charts at cohort enrolment and at quarterly visits throughout the follow-up. Mixed models were used to explore factors associated with this score. At enrolment, 190 individuals (62%) reported poor overall health. In the multivariate analysis, low CD4 percentage, co-infection with hepatitis C or D viruses, HIV diagnosis before 1996 and HBeAg positivity were independently associated with poor perceived overall health. Poor perceived health concerns a considerable portion of individuals living with HIV and HBV. Individuals with wild-type HBV and multiple hepatitis infection require better clinical management. Further research is needed for hepatitis D virus infection, for which treatment options are currently very limited.
authors.affiliation: INSERM, U912 (SE4S), Marseille, France. fabienne.marcellin@inserm.fr
authors.forename: Fabienne
authors.initials: F
authors.lastname: Marcellin
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.forename: Lionel
authors.initials: L
authors.lastname: Fugon
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
authors.forename: Philippe
authors.initials: P
authors.lastname: Bonnard
authors.forename: Patrick
authors.initials: P
authors.lastname: Miailhes
authors.forename: Caroline
authors.initials: C
authors.lastname: Lascoux-Combe
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.forename: Maria P
authors.initials: MP
authors.lastname: Carrieri
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
mesh_terms: D000328:Adult; D000342:Affective Symptoms; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology; D006679:HIV Seropositivity / Q000188:drug therapy; D006304:Health Status; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000523:psychology; D006526:Hepatitis C / Q000150:complications*; D003699:Hepatitis D / Q000150:complications*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012647:Self-Assessment; D013997:Time Factors