title: Impact of hepatitis coinfection on healthcare utilization among persons living with HIV.
abstract: : Hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection are increasingly important sources of morbidity among HIV-infected persons. We determined associations between hepatitis coinfection and healthcare utilization among HIV-infected adults at 4 US sites during 2006-2011. Outpatient HIV visits did not differ by hepatitis serostatus and decreased over time. Mental health visits were more common among HIV/HCV coinfected persons than among HIV monoinfected persons [incidence rate ratio (IRR): 1.27, 95% confidence interval (CI): 1.08 to 1.50]. Hospitalization rates were higher among all hepatitis-infected groups than among HIV monoinfected (HIV/HBV: IRR: 1.23, 95% CI: 1.05 to 1.44; HIV/HCV: IRR: 1.22, 95% CI: 1.10 to 1.36; HIV/HBV/HCV: IRR: 1.31, 95% CI: 1.02 to 1.68). These findings may inform the design of clinical services and allocation of resources.
authors.affiliation: *Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; †Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD; ‡Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University, Portland, OR; and §Division of Infectious Disease, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Crowell
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Berry
authors.forename: John A
authors.initials: JA
authors.lastname: Fleishman
authors.forename: Richard W
authors.initials: RW
authors.lastname: LaRue
authors.forename: Philip T
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Ank E
authors.initials: AE
authors.lastname: Nijhawan
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Gebo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D060085:Coinfection / Q000628:therapy*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000628:therapy*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000628:therapy*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D014481:United States; D055815:Young Adult