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40% HCV Prevalence in HIV Clinic in SF
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VIRAL HEPATITIS AND LIVER INJURY IN AN HIV COMMUNITY NETWORK
AASLD conference, Dallas Nov 2001 (abstract 1258)
Charles B Hare, Mark Jacobson, Jessica Watson, Dustin G Mark, Marion G Peters, Univ of CA at San francisco, San Francisco, CA
BACKGROUND: Co-infection with viral hepatitis is an increasing issue in HIV subjects. The extent to which co-infection compounds chronic liver injury or exacerbates drug and alcohol toxicity is not completely defined. AIM: To evaluate the prevalence of viral hepatitis and the association of viral hepatitis and liver injury in an HIV positive community population.
METHODS: Adult patients infected with HIV who received care at Community Health Network, San Francisco from July 1996 through June 2000 were included. We reviewed serum aminotransferases (ALT), alkaline phosphatase (Alk Phos) and serologic testing for Hepatitis B and C, including HBsAg, anti-HBc total and HCV Ab.
RESULTS: Of 4099 HIV positive patients, serology was available on 3116 subjects (76%). Of 2458 subjects tested for HBsAg, 218 (8.9%) were positive. Of 1776 tested for total antibody to HBc, 1240 (69.8%) were positive.
Of 2859 tested for HCV Ab, 1126 (39.4%) were positive. Serum ALT and Alk Phos was studied in patients in whom measurements were available over a period of one year or more, stratified according to hepatitis status as shown in the table.
CONCLUSION: Viral Hepatitis is common in HIV patients. In this community population, 76% of patients were tested for hepatitis. Of these 39.4% of patients were co-infected with HCV and 8.9% with Hepatitis B. It is not clear how many of the 69.8% of anti-HBc alone patients had latent disease or were viremic. Liver inflammation is common in this population. There is a higher incidence of abnormal liver enzymes in patients co-infected with viral hepatitis, HBV more than HCV. This is of great significance when treating patients with HAART.
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