title: Risk of liver-associated morbidity and mortality in a cohort of HIV and HBV coinfected Han Chinese.
abstract: OBJECTIVE
  To investigate the incidence and risk factors of liver-associated morbidity and mortality in Han Chinese patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection.
  
  
  METHODS
  A retrospective study was conducted.
  
  
  RESULTS
  Of the 255 subjects with HIV and HBV coinfection, 181 (71.0%) received lamivudine-based combined antiretroviral therapy (cART). Of the patients, 49/255 (19.2%) developed advanced liver diseases (ALDs) (during 5.2 years): 30 patients developed clinically overt cirrhosis, 10 developed hepatocellular carcinoma and 9 developed severe reactivation of a preexisting chronic hepatitis B. Baseline CD4(+) cell count <200 cell/mm(3) (P = 0.013, OR = 6.503), baseline alanine aminotransferase (ALT) elevation (P = 0.011, OR = 14.456), and longer cumulated time with detectable HIV RNA (P = 0.008, OR = 1.814) and HBV DNA (P = 0.014, OR = 1.536) were risk factors for ALDs development, while CD4(+) cell count changes ≥150 cells/mm(3) within 3 months (P = 0.039, OR = 0.049) and the use of lamivudine-based cART (P = 0.030, OR = 0.034) were protective against ALDs development.
  
  
  CONCLUSIONS
  ALDs was common among HIV and HBV coinfected Han Chinese patients. Lamivudine-based cART was beneficial in terms of sustained HBV viral suppression and resulted in less incidence of ALDs.
authors.affiliation: Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuchang, Wuhan, China.
authors.forename: R
authors.initials: R
authors.lastname: Yang
authors.forename: X
authors.initials: X
authors.lastname: Gui
authors.forename: Y
authors.initials: Y
authors.lastname: Xiong
authors.forename: S
authors.initials: S
authors.lastname: Gao
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: L
authors.initials: L
authors.lastname: Deng
authors.forename: K
authors.initials: K
authors.lastname: Liang
authors.forename: Y
authors.initials: Y
authors.lastname: Yan
authors.forename: Y
authors.initials: Y
authors.lastname: Rong
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002681:China; D015331:Cohort Studies; D060085:Coinfection / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006678:HIV / Q000187:drug effects / Q000235:genetics; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000235:genetics / Q000821:virology*; D006509:Hepatitis B / Q000150:complications / Q000821:virology*; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000150:complications / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral; D019259:Lamivudine; D000410:Alanine Transaminase