Hepatitis B and C infection and liver disease trends among human immunodeficiency virus-infected individuals

AIM：To examine trends in and correlates of liver disease and viral hepatitis in an human immunodeficiency virus （HIV）-infected cohort. METHODS：The multi-site adult/adolescent spectrum of HIV-related diseases （ASD） followed 29 490 HIVinfected individuals receiving medical care in 11 U.S. metropolitan areas for an average of 2.4 years,and a total of 69 487 person-years,between 1998 and 2004. ASD collected data on the presentation,treatment,and outcomes of HIV,including liver disease,hepatitis screening,and hepatitis diagnoses. RESULTS：Incident liver disease,chronic hepatitis B virus （HBV）,and hepatitis C virus （HCV） were diagnosed in 0.9,1.8,and 4.7 per 100 person-years. HBV and HCV screening increased from fewer than 20% to over 60% during this period of observation （P 0.001）. Deaths occurred in 57% of those diagnosed with liver disease relative to 15% overall （P 0.001）. Overall 10% of deaths occurred among individuals with a diagnosis of liver disease. Despite care guidelines promoting screening and vaccination for HBV and screening for HCV,screening and vaccination were not universally conducted or,if conducted,not documented. CONCLUSION：Due to high rates of incident liver disease,viral hepatitis screening,vaccination,and treatment among HIV-infected individuals should be a priority.