Impact of hepatitis B and C co-infection on health-related quality of life in HIV positive individuals
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- Gillis, J., Cooper, C., Rourke, S. et al. Qual Life Res (2013) 22: 1525. doi:10.1007/s11136-012-0283-7
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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.
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.
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.
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.