title: Long-Term Liver Diseases after Initiation of Antiretroviral Therapy in HIV-Infected Patients with and without HBV or HCV Coinfection.
abstract: Coinfection of hepatitis B virus (HBV) or hepatitis C virus (HCV) with HIV is common and associated with increased mortality and increased risk of progression to chronic liver disease. We aimed to study long-term liver diseases after initiation of antiretroviral therapy (ART) in HIV-infected patients with and without HBV or HCV coinfection. A retrospective cohort of 92 patients (32 patients with HBV and/or HCV coinfection) was analyzed. Overall mean age was 38.3 years, and 54.3% were males. Immunological and virological responses were similar between the 2 groups ( P > .05). During a median follow-up period of 6.1 years, 12 (13.0%) patients had liver diseases. Kaplan-Meier analysis showed that the coinfection group had a significantly higher probability of developing liver diseases after ART (log-rank test, P < .001). Among the subgroup of 32 patients with coinfection, patients who were initiated ART at CD4 count <200 cells/mm3had a higher rate of liver diseases compared to those who were initiated ART at CD4 count ≥200 cells/mm3(42.3% versus 16.7%; P = .004).
authors.affiliation: 1 Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sithakom
authors.initials: S
authors.lastname: Phusanti
authors.affiliation: 1 Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kwanhatai
authors.initials: K
authors.lastname: Manosudprasit
authors.affiliation: 2 Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Somnuek
authors.initials: S
authors.lastname: Sungkanuparph
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002908:Chronic Disease; D060085:Coinfection / Q000453:epidemiology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D006509:Hepatitis B / Q000453:epidemiology / Q000821:virology; D006526:Hepatitis C / Q000453:epidemiology / Q000821:virology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D044966:Anti-Retroviral Agents
keywords: HBV; HCV; HIV; antiretroviral therapy; coinfection; liver disease