Quality of Life Research

, Volume 22, Issue 7, pp 1525–1535

Impact of hepatitis B and C co-infection on health-related quality of life in HIV positive individuals

  • Jennifer Gillis
  • Curtis Cooper
  • Sean Rourke
  • Sergio Rueda
  • Kelly O’Brien
  • Evan Collins
  • Anita Rachlis
  • Trevor A. Hart
  • Janet Raboud
  • the OHTN Cohort Study Group
Article

DOI: 10.1007/s11136-012-0283-7

Cite this article as:
Gillis, J., Cooper, C., Rourke, S. et al. Qual Life Res (2013) 22: 1525. doi:10.1007/s11136-012-0283-7

Abstract

Purpose

Concurrent infection with HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) often occurs due to the commonality in risk factors for acquisition. Few studies have examined the effect of co-infection on health-related quality of life (HRQOL) in HIV positive individuals.

Methods

Ontario HIV Treatment Network Cohort Study (OCS) participants who completed an annual interviewer-administered questionnaire on up to three occasions were included. Generalized estimating equations (GEE) were used to assess the impact of HBV and HCV co-infection on physical and mental HRQOL component summary scores (range 0–100) as measured by the Medical Outcomes SF-36 health survey.

Results

As of March 2010, 1,223 participants had completed the questionnaire; 964 were HIV mono-infected, 128 were HIV–HBV co-infected, 112 were HIV–HCV co-infected, and 19 were HIV–HBV–HCV tri-infected. Eighty percent were male, median age 46 (IQR 40–53) years, 61 % Caucasian, median CD4 count 464 (IQR 319–636) cells/mm3, and 74 % had undetectable HIV viremia. Physical HRQOL was lower in HIV–HBV and HIV–HCV co-infected individuals (49.4 (IQR 42.0–53.9) and 48.1 (IQR 36.9–52.8) vs. 51.5 (IQR 45.0–55.4); p = 0.01 and <0.0001) compared to mono-infected individuals. In the multivariable GEE model, the negative impact of HCV remained significant (−2.18; p = 0.01) after adjusting for drug use, smoking, age, and gender. Unadjusted mental HRQOL was lower in HIV–HCV co-infected individuals (44.6 (IQR 34.6–54.0) vs. 48.9 (IQR 36.8–55.9); p = 0.03) compared to mono-infected individuals but no association of mental HRQOL with either co-infection was observed in multivariable GEE models.

Conclusions

HCV appears to negatively impact physical HRQOL suggesting a greater health burden for co-infected individuals. HBV and HCV co-infections were not related to lower mental HRQOL among people living with HIV/AIDS.

Keywords

HepatitisHIVQuality of lifeCo-infection

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Jennifer Gillis
    • 1
  • Curtis Cooper
    • 2
  • Sean Rourke
    • 3
    • 4
    • 5
    • 6
  • Sergio Rueda
    • 5
    • 6
  • Kelly O’Brien
    • 7
    • 8
  • Evan Collins
    • 6
    • 12
  • Anita Rachlis
    • 3
    • 9
  • Trevor A. Hart
    • 10
    • 11
  • Janet Raboud
    • 1
    • 11
  • the OHTN Cohort Study Group
  1. 1.Clinical Decision Making and Health Care, Toronto General HospitalUniversity Health NetworkTorontoCanada
  2. 2.The Ottawa Hospital Division of Infectious DiseasesUniversity of OttawaOttawaCanada
  3. 3.Departments of Medicine and Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  4. 4.Division of General Internal Medicine, Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoCanada
  5. 5.Ontario HIV Treatment NetworkTorontoCanada
  6. 6.Department of PsychiatryUniversity of TorontoTorontoCanada
  7. 7.School of Rehabilitation ScienceMcMaster UniversityHamiltonCanada
  8. 8.Department of Physical TherapyUniversity of TorontoTorontoCanada
  9. 9.Division of Infectious DiseasesSunnybrook Health Sciences CentreTorontoCanada
  10. 10.Department of PsychologyRyerson UniversityTorontoCanada
  11. 11.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  12. 12.Immunodeficiency Clinic, Toronto General HospitalUniversity Health NetworkTorontoCanada