title: Hepatitis B and C Co-Infection in HIV Patients from the TREAT Asia HIV Observational Database: Analysis of Risk Factors and Survival.
abstract: BACKGROUND
  We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region.
  
  
  METHODS
  Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test.
  
  
  RESULTS
  A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive.
  
  
  CONCLUSIONS
  In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality.
authors.affiliation: Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.|Department of Cosmetic Applications and Management, MacKay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wing-Wai
authors.initials: WW
authors.lastname: Wong
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Law
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sasisopin
authors.initials: S
authors.lastname: Kiertiburanakul
authors.affiliation: Working Group on AIDS Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Evy
authors.initials: E
authors.lastname: Yunihastuti
authors.affiliation: Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia.
authors.forename: Tuti Parwati
authors.initials: TP
authors.lastname: Merati
authors.affiliation: Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Poh Lian
authors.initials: PL
authors.lastname: Lim
authors.affiliation: Research Institute for Health Sciences, Chiang Mai, Thailand.
authors.forename: Romanee
authors.initials: R
authors.lastname: Chaiwarith
authors.affiliation: HIV-NAT/ Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
authors.forename: Praphan
authors.initials: P
authors.lastname: Phanuphak
authors.affiliation: Queen Elizabeth Hospital, Hong Kong, China.
authors.forename: Man Po
authors.initials: MP
authors.lastname: Lee
authors.affiliation: Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India.
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
authors.affiliation: National Center for HIV/AIDS, Dermatology & STDs, and University of Health Sciences, Phnom Penh, Cambodia.
authors.forename: Vonthanak
authors.initials: V
authors.lastname: Saphonn
authors.affiliation: Research Institute for Tropical Medicine, Manila, Philippines.
authors.forename: Rossana
authors.initials: R
authors.lastname: Ditangco
authors.affiliation: Hospital Sungai Buloh, Sungai Buloh, Malaysia.
authors.forename: Benedict L H
authors.initials: BL
authors.lastname: Sim
authors.affiliation: National Hospital for Tropical Diseases, Hanoi, Vietnam.
authors.forename: Kinh Van
authors.initials: KV
authors.lastname: Nguyen
authors.affiliation: Institute of Infectious Diseases, Pune, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Pujari
authors.affiliation: University Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Adeeba
authors.initials: A
authors.lastname: Kamarulzaman
authors.affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing, China.
authors.forename: Fujie
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Thuy Thanh
authors.initials: TT
authors.lastname: Pham
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.affiliation: National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
authors.affiliation: Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
authors.forename: Pacharee
authors.initials: P
authors.lastname: Kantipong
authors.affiliation: Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia.
authors.forename: Mahiran
authors.initials: M
authors.lastname: Mustafa
authors.affiliation: Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Winai
authors.initials: W
authors.lastname: Ratanasuwan
authors.affiliation: TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Durier
authors.affiliation: Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Microbiology and Institute of Medical Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yi-Ming Arthur
authors.initials: YM
authors.lastname: Chen
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001208:Asia / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D060085:Coinfection / Q000150:complications* / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1 / Q000187:drug effects / Q000302:isolation & purification; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents