Incidence of hepatocellular carcinoma in patients with chronic liver disease due to hepatitis B or C and coinfected with the human immunodeficiency virus: A retrospective cohort study

Abstract Background Why some persons living with human immunodeficiency virus (HIV) (PLWH) progress quickly and others remain “healthy” for a decade or more without treatment remains a fundamental question of HIV pathology. We aimed to assess the epidemiological characteristics of HIV long-term nonprogressors (LTNPs) based on a cohort of PLWH in China observed between 1989 and 2016. Methods We conducted a nationwide, retrospective cohort study among Chinese PLWH with HIV diagnosed before 1 January 2008. Records were extracted from China’s national HIV/AIDS database on 30 June 2016. LTNPs were defined as those with AIDS-free, antiretroviral therapy–naive survival, with CD4 cell counts consistently ≥500/μL for ≥8 years after diagnosis. Prevalence was calculated, characteristics were described, and determinants were assessed by means of logistic regression. Potential sources of bias were also investigated. Results Our cohort included 89 201 participants, of whom 1749 (2.0%) were categorized as LTNPs. The injection drug use (IDU) route of infection was reported by 70.7% of LTNPs, compared with only 37.1% of non-LTNPs. The odds of LTNP status were greater among those infected via IDU (adjusted odds ratio [95% confidence interval], 2.28 [1.94–2.68]) and with HIV diagnosed in settings with large populations of persons who inject drugs (1.75 [1.51–2.02] for detention centers, 1.61 [1.39–1.87] for Yunnan, 1.94 [1.62–2.31] for Guangdong, and 2.90 [2.09–4.02] for Xinjiang). Conclusions Overrepresentation of the IDU route of infection among LTNPs is a surprising finding worthy of further study, and this newly defined cohort may be particularly well suited to exploration of the molecular biological mechanisms underlying HIV long-term nonprogression.

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Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

BMC Gastroenterology ◽

10.1186/s12876-020-01473-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Xing-Ran Zhai ◽

Jing-Jing Tong ◽

Hong-Min Wang ◽

Xiang Xu ◽

Xiu-Ying Mu ◽

...

Keyword(s):

Septic Shock ◽

Cohort Study ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Liver Failure ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Chronic Liver ◽

Chronic Liver Failure ◽

B Virus

Abstract Background Infection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in patients with HBV-ACLF defined by EASL in China. Methods We performed a retrospective cohort study in patients with HBV-ACLF defined by EASL in a single center from January 2015 to December 2017. These patients were divided into two groups with and without infection. The incidence, sites of infection, isolated strains, and risk factors associated with mortality were evaluated. Results A total of 289 patients were included, among them 185 (64.0%) were diagnosed with an infection. The most common type of infection was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P < 0.01), septic shock (P < 0.001), and ACLF-3 (P < 0.05). Also, patients with infection isolated one, two, and three or more strains showed a growing incidence of sepsis (P < 0.01) and septic shock (P < 0.001). Patients with infection showed a significantly higher 28-day mortality than those without (P < 0.01), especially in patients with ACLF-3. Infection was identified as an independent risk factor for 28-day mortality in all HBV-ACLF patients. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for patients with infection. Conclusions Infection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased number of infection sites or isolated strains was associated with the occurrence of sepsis and septic shock. Pneumonia and sepsis were independent predictors for mortality in HBV-ACLF patients with infection.

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Psychosocial adjustment in perinatally human immunodeficiency virus infected or exposed children - a Retrospective Cohort Study

Journal of the International AIDS Society ◽

10.7448/ias.19.1.20694 ◽

2016 ◽

Vol 19 (1) ◽

pp. 20694 ◽

Cited By ~ 8

Author(s):

Sarah K Zalwango ◽

Florence N Kizza ◽

Allan K Nkwata ◽

Juliet N Sekandi ◽

Robert Kakaire ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Cohort Study ◽

Psychosocial Adjustment ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Immunodeficiency Virus

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Temporary disengagement and re-engagement in human immunodeficiency virus care in a rural county serving pastoralist communities in Kenya: a retrospective cohort study

International Health ◽

10.1093/inthealth/ihz049 ◽

2019 ◽

Vol 12 (2) ◽

pp. 95-100

Author(s):

Paul Yonga ◽

Stephen Kalya ◽

Lutgarde Lynen ◽

Tom Decroo

Keyword(s):

Human Immunodeficiency Virus ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Retention In Care ◽

Virologic Response ◽

World Health ◽

Hiv Care ◽

Pastoralist Communities ◽

Immunodeficiency Virus

Abstract Background Pastoralist communities are known to be hard to reach. The magnitude of temporary disengagement from human immunodeficiency virus (HIV) care is understudied. Methods We conducted a retrospective cohort study of temporary disengagement (2 weeks late for a next appointment), virologic response, lost to follow-up (6 months late) and re-engagement in care among patients who started antiretroviral therapy between 2014 and 2016 in Baringo County, Kenya. Predictors of re-engagement after disengagement were estimated using logistic regression. Results Of 342 patients, 76.9% disengaged at least once (range 0–7). Of 218 patients with a viral load (VL), 78.0% had a suppressed VL. Those with a history of temporary disengagement from care were less likely to suppress their VL (p=0.002). Six patients had treatment failure (two consecutive VLs >1000 copies/mm3) and all had disengaged at least once. After disengagement from care, male patients (adjusted odds ratio [aOR] 0.3 [95% confidence interval {CI} 0.2 to 0.6]; p<0.001) and patients with World Health Organization stage III–IV (aOR 0.3 [95% CI 0.1 to 0.5; p<0.001) were less likely to re-engage in care. Conclusions Temporary disengagement was frequent in this pastoralist setting. This indicator is often overlooked, as most studies only report binary outcomes, such as retention in care. Innovative strategies are required to achieve HIV control in rural settings like this pastoralist setting.

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