NAM / Aidsmap tell us about a new study that shows chronic infection with hep-B is associated with twice the risk of death compared to chronic hep-C infection among people with HIV. Click the headline for more.
Long-term(or chronic) infection with hepatitis B virus is associated with twice the riskof death compared to chronic hepatitis C virus infection, US research shows.
Many people with HIV also have hepatitis B and/or hepatitis C (often referred to as co-infection). Liver disease caused by these viruses is now an important cause of death in people with HIV and hepatitis co-infection.
However, there has been uncertainty as to which infection is causing the most liver-related disease and death.
Researchers from the large Multicenter AIDS Cohort Study (MACS) therefore looked at rates of liver-related death in 680 men with chronic hepatitis B or C.
Equal proportions were infected with hepatitis B and hepatitis C, and approximately 70% were also infected with HIV.
The rate of liver-related death was twice as high in people with hepatitis B compared to people with hepatitis C.
For the people with HIV, a CD4 cell count below 200 increased the risk of liver-related death, as did older age. Patients with hepatitis co-infection are especially encouraged to start HIV treatment before their CD4 cell count falls below 350 and sometimes sooner.
Rates of hepatitis C-related deaths were similar in the periods before and after effective HIV treatment became available.
However, there was a slight decline in hepatitis B-related deaths after the introduction of anti-HIV drugs such as 3TC, FTC and tenofovir. These drugs also work against hepatitis B.
There is an effective hepatitis B vaccine and it is recommended for everyone with HIV. Liver health is monitored as part of routine HIV care. You can find out more about HIV and hepatitis B and hepatitis C co-infection in the NAM booklet HIV & hepatitis.