Author:
Seyoum Eleni,Demissie Meaza,Worku Alemayehu,Mihret Adane,Abdissa Alemseged,Berhane Yemane
Abstract
Abstract
Background
HIV coinfection with viral hepatitis B (HBV) or viral hepatitis C (HCV) is not uncommon in Ethiopia. Although the coinfections are presumed to interfere with antiretroviral treatment (ART), this is not widely studied in Sub-Saharan African settings. This study was conducted to determine ART retention in persons coinfected with HIV + HBV or HIV + HCV.
Methods
We reviewed the medical records of HIV-positive adults who initiated ART between 2011 to 2018 in four high-burden hospitals of Addis Ababa. Retention in care was the primary outcome of the study, which was compared between HIV and either HBV or HCV coinfected persons, and HIV-monoinfected persons. A parametric Gompertz regression model was used to compare retention between the coinfected and monoinfected groups.
Results
A total of 132 coinfected persons and 514 HIV-monoinfected individuals who initiated ART in 2011–2018 were compared. At 12-months of follow-up, 81.06% [95% CI: 73.3–86.9%] of the coinfected and 86.96% [95% CI: 83.7–89.6%] of the monoinfected were still on ART care. Cumulative retention in the coinfected group was 68.93% [60.4–76.3%] versus 80.35% [76.6–83.5%, p = 0.0048] in the monoinfected group. The cumulative retention was lower (61.25, 95% CI: 49.9–71.4%) in male coinfected patients than male monoinfected patients (77.77, 95% CI: 71.8–82.7%, p = 0.0041). In contrast, cumulative retention was similar in females in the coinfected group (80.76, 95% CI:67.3–89.5%) versus the monoinfected group (82.29, 95% CI:77.4–86.3%, p = 0.792). Overall, HIV-positive with viral hepatitis coinfection were 24 and 31% less likely to still be on ART care than the monoinfected group at 12 months and overall, with sub-distribution adjusted hazard ratio (AHR) of 0.76(95% CI:0.61–0.96, p = 0.021) and 0.69(95% CI:0.54–0.87, p = 0.002) respectively.
Conclusions
We observed that coinfected individuals are less likely to stay on ART than HIV monoinfected individuals. The low retention in the coinfected group from this study may affect the success of survival gained in people living with HIV (PLHIV) in the long term. More concerted efforts need to be made to retain coinfected individuals at least at the level of monoinfected persons on long-term ART care. Future studies are needed to better understand the difference in retention, preferable in a prospective manner.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference36 articles.
1. Joint United Nations Programme on HIV/AIDS. Global HIV & AIDS statistics [Internet]. 2020 [cited 2021 Apr 4]. Available from: https://www.unaids.org/en/resources/fact-sheet
2. World Health Organization. HIV and hepatitis coinfections [Internet]. 2020 [cited 2021 Jan 14]. Available from: http://www.who.int/hiv/topics/hepatitis/hepatitisinfo/en/
3. Ladep NG, Agbaji OO, Agaba PA, Muazu A, Ugoagwu P, Imade G, et al. Hepatitis B Co-Infection is Associated with Poorer Survival of HIV-Infected Patients on Highly Active Antiretroviral Therapy in West Africa. J AIDS Clin Res [Internet]. 2013 Jun 29 [cited 2021 Jan 14];Suppl 3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199237/
4. Chen M, Wong W-W, Law MG, Kiertiburanakul S, Yunihastuti E, Merati TP, et al. Hepatitis B and C co-infection in HIV patients from the TREAT Asia HIV observational database: analysis of risk factors and survival. PLoS ONE [Internet]. 2016; Mar 2 [cited 2021 Jan 14];11(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4774987/.
5. Andreoni M, Giacometti A, Maida I, Meraviglia P, Ripamonti D, Sarmati L. HIV-HCV co-infection: epidemiology, pathogenesis and therapeutic implications. Eur Rev Med Pharmacol Sci. 2012 Oct;16(11):1473–83.
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