Impact of HBV/HCV on Hospitalization in HIV+ Persons
Impact of HBV/HCV on Hospitalization in HIV+ Persons
Chronic viral hepatitis is common among persons living with HIV (PLWH). In the United States, Europe, and Australia, approximately 4.8%–9.0% of PLWH are also chronically infected with hepatitis B virus (HBV), 20%–33% are chronically infected with hepatitis C virus (HCV), and 0.5%–4.0% are chronically infected with both. Patients with HIV/HBV coinfection experience faster progression to cirrhosis, more hepatocellular carcinoma, and higher risk of liver-related mortality than patients with either infection alone. Similarly, liver disease progression and its complications are more common in HIV/HCV coinfected patients than in HIV monoinfected patients. Viral hepatitis, particularly HCV, has also been associated with extrahepatic complications that can include renal disease, cardiovascular disease, diabetes, autoimmunity, metabolic bone disease, and neurocognitive decline.
In the era of potent and widely available antiretroviral therapy (ART), hospitalization rates have become an important outcome measure and an important health care cost among PLWH. Comparing rates and reasons for hospitalizations among PLWH with and without hepatitis coinfection will be important to clinicians and policy-makers trying to understand the health care needs of these populations. Differences across these populations could suggest areas of unique clinical need and may influence the allocation of health care resources and the construction of health care delivery models. The purpose of this study was to characterize the impact of hepatitis coinfection on inpatient health care utilization among HIV-infected patients in a multi-site, multi-state consortium of HIV care sites.
Background
Chronic viral hepatitis is common among persons living with HIV (PLWH). In the United States, Europe, and Australia, approximately 4.8%–9.0% of PLWH are also chronically infected with hepatitis B virus (HBV), 20%–33% are chronically infected with hepatitis C virus (HCV), and 0.5%–4.0% are chronically infected with both. Patients with HIV/HBV coinfection experience faster progression to cirrhosis, more hepatocellular carcinoma, and higher risk of liver-related mortality than patients with either infection alone. Similarly, liver disease progression and its complications are more common in HIV/HCV coinfected patients than in HIV monoinfected patients. Viral hepatitis, particularly HCV, has also been associated with extrahepatic complications that can include renal disease, cardiovascular disease, diabetes, autoimmunity, metabolic bone disease, and neurocognitive decline.
In the era of potent and widely available antiretroviral therapy (ART), hospitalization rates have become an important outcome measure and an important health care cost among PLWH. Comparing rates and reasons for hospitalizations among PLWH with and without hepatitis coinfection will be important to clinicians and policy-makers trying to understand the health care needs of these populations. Differences across these populations could suggest areas of unique clinical need and may influence the allocation of health care resources and the construction of health care delivery models. The purpose of this study was to characterize the impact of hepatitis coinfection on inpatient health care utilization among HIV-infected patients in a multi-site, multi-state consortium of HIV care sites.
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