Clinical Characteristics of Hepatitis B and C Virus Infections in HIV-Infected Patients
Prapinpa Phuangchoei MD*, Watcharasak Chotiyaputta MD**, Methee Chayakulkeeree MD, PhD***
Affiliation : * Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Hepatitis B virus (HBV) and hepatitis C virus (HCV) share a common route of transmission with human
immunodeficiency virus (HIV). HIV co-infected with HBV or HCV was associated with a progression to severe liver disease,
increased risk of hepatotoxicity from antiretroviral therapy and reduced survival. Data regarding HBV and HCV infection
in HIV-positive individuals in Thailand is limited.
Objectives: To investigate the prevalence and clinical characteristics of HBV and HCV infection in HIV-infected patients
in Siriraj Hospital.
Material and Method: A retrospective study was conducted in adult HIV-positive followed up at the Infectious Disease
Clinic, Siriraj Hospital. Prevalence of HBV and HCV infections and clinical characteristics were analyzed.
Results : 250 HIV-positive patients were enrolled, mean age was 38.8 years and 57.2% were male. HBV infection was found
in 6.5% (15/231), and HCV infection was 7.7% (17/222). One patient had both HBV and HCV infections. In multivariate
analysis, factors associated with either HBV or HCV co-infection included male gender (77.4% vs. 55%; p 0.008), history
of salmonellosis (9.7% vs. 2.5%; p 0.042) or elevated serum alanine aminotransferase (ALT) level (34 U/L vs. 25 U/L;
p 0.018). Factors associated with HBV infection, compared with those without hepatitis virus infection, included male gender
(86.7% vs. 56%; p 0.038), history of salmonellosis (20% vs. 2.3%; p 0.005), elevated serum ALT level (42 U/L vs. 25 U/L;
p 0.012) and low CD4 percent (1.05% vs. 5.02%; p 0.04). In this study, we did not find any factor associated with HCV
infection in HIV patients.
Conclusion : The prevalence of HBV and HCV infection in HIV-infected Thai patients is significant. Male gender, history
of salmonellosis, elevated serum ALT levels, and low CD4 percent are associated with HBV co-infection.
Keywords : HIV infection, Hepatitis B, Hepatitis C, HBV, HCV, AIDS
