Correlates of poor perceived health among individuals living with HIV and HBV chronic infections: a longitudinal assessment

Abstract

Chronic hepatitis B virus (HBV) infection affects up to 14% of people living with HIV and AIDS (PLWHA) and is associated with a higher risk of non-AIDS death. While great advances have been made in the therapeutic management of co-infection with HIV and HBV, nothing is known about perceived health in people living with HIV and HBV. This study aimed at characterizing individuals with poor perceived overall health among 308 HIV–HBV co-infected individuals enrolled between May 2002 and May 2003 in a three-year French cohort. A binary score for perceived overall health (good vs. poor) was calculated from individuals’ responses to the COOP-WONCA charts at cohort enrolment and at quarterly visits throughout the follow-up. Mixed models were used to explore factors associated with this score. At enrolment, 190 individuals (62%) reported poor overall health. In the multivariate analysis, low CD4 percentage, co-infection with hepatitis C or D viruses, HIV diagnosis before 1996 and HBeAg positivity were independently associated with poor perceived overall health. Poor perceived health concerns a considerable portion of individuals living with HIV and HBV. Individuals with wild-type HBV and multiple hepatitis infection require better clinical management. Further research is needed for hepatitis D virus infection, for which treatment options are currently very limited.

Keywords:

• cohort study
• co-infection
• hepatitis B
• HIV
• perceived health

Acknowledgements

The authors would like to thank Jude Sweeney for the English revision and editing of the manuscript. This work was funded by SIDACTION, the French national agency for research on HIV/AIDS and viral hepatitis (ANRS, Agence Nationale de Recherches sur le Sida et les hépatites virales), with a special grant from Gilead Sciences, and sponsored by IMEA (Institut de Médecine et d'Epidémiologie Appliquée).