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Impact of Socio‐Economic, Behavioural and Clinical Factors on Liver Disease Progression in Individuals With HIV and Hepatitis B

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Title: Impact of Socio‐Economic, Behavioural and Clinical Factors on Liver Disease Progression in Individuals With HIV and Hepatitis B
Authors: Clémence Ramier, Anders Boyd, Colette Smit, Rosan van Zoest, Mark A. A. Claassen, Katalin Pogány, Dirk Posthouwer, Theodora E. M. S. de Vries‐Sluijs, Patrizia Carrieri, Marc Van der Valk
Source: Liver Int
Publisher Information: Wiley, 2025.
Publication Year: 2025
Subject Terms: Male, Adult, socioeconomy, Netherlands/epidemiology, Liver Cirrhosis/epidemiology, Risk Factors, Humans, Coinfection/epidemiology, hepatitis, Proportional Hazards Models, Liver Neoplasms/epidemiology, urbanisation, Incidence, Carcinoma, HIV, Middle Aged, Hepatitis B, HIV Infections/complications epidemiology, behaviour, Socioeconomic Factors, Disease Progression, Chronic/complications epidemiology, Female, Original Article, liver disease, Hepatocellular/epidemiology
Description: Background and AimsLittle is known about the contribution of sociodemographic and behavioural factors to developing liver disease in individuals with an HIV and chronic hepatitis B virus (HBV) co‐infection. We aimed to quantify the impact of these factors on incident liver disease in individuals with HIV/HBV receiving care in the Netherlands.MethodsWe used data from the Dutch observational ATHENA cohort combined with Statistics Netherlands. We included all hepatitis B surface antigen‐positive individuals with HIV in care from 2008–2022. Severe liver disease (i.e., significant fibrosis (≥F2), cirrhosis, hepatocellular carcinoma, liver transplantation) was defined by physician diagnosis or a transient elastography result > 7 kPa. Determinants of incident liver disease were assessed using Cox proportional hazard models.ResultsIn the 1319 individuals included (12,277 person‐years (PY); 93.3% HIV‐RNA 25 kg/m2 increased the risk of liver disease [adjusted hazards ratio (aHR) = 2.33, 95% CI = 1.38–3.94; aHR = 4.00, 95% CI = 2.18–7.33, aHR = 1.75, 95% CI = 1.05–2.92, respectively]. Conversely, men who have sex with men (vs. other transmission routes, aHR = 0.54, 95% CI = 0.32–0.90), and individuals living in an urbanised municipality (aHR = 0.50, 95% CI = 0.30–0.85) had a reduced risk of liver disease.ConclusionsLiver disease progression in people living with HIV/HBV appears to be linked to psychosocial/behavioural factors. More effective screening/management of coinfection and metabolic syndrome, as well as strategies for smoking cessation, should be included in clinical follow‐up.
Document Type: Article
Other literature type
Language: English
ISSN: 1478-3231
1478-3223
DOI: 10.1111/liv.70191
Access URL: https://cris.maastrichtuniversity.nl/en/publications/9ff8529a-0756-4875-bf1e-48252dce9fb8
https://doi.org/10.1111/liv.70191
Rights: CC BY NC ND
URL: http://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Accession Number: edsair.doi.dedup.....13dde53f39da4f62f3c9010053b53ca4
Database: OpenAIRE
Description
Abstract:Background and AimsLittle is known about the contribution of sociodemographic and behavioural factors to developing liver disease in individuals with an HIV and chronic hepatitis B virus (HBV) co‐infection. We aimed to quantify the impact of these factors on incident liver disease in individuals with HIV/HBV receiving care in the Netherlands.MethodsWe used data from the Dutch observational ATHENA cohort combined with Statistics Netherlands. We included all hepatitis B surface antigen‐positive individuals with HIV in care from 2008–2022. Severe liver disease (i.e., significant fibrosis (≥F2), cirrhosis, hepatocellular carcinoma, liver transplantation) was defined by physician diagnosis or a transient elastography result > 7 kPa. Determinants of incident liver disease were assessed using Cox proportional hazard models.ResultsIn the 1319 individuals included (12,277 person‐years (PY); 93.3% HIV‐RNA 25 kg/m2 increased the risk of liver disease [adjusted hazards ratio (aHR) = 2.33, 95% CI = 1.38–3.94; aHR = 4.00, 95% CI = 2.18–7.33, aHR = 1.75, 95% CI = 1.05–2.92, respectively]. Conversely, men who have sex with men (vs. other transmission routes, aHR = 0.54, 95% CI = 0.32–0.90), and individuals living in an urbanised municipality (aHR = 0.50, 95% CI = 0.30–0.85) had a reduced risk of liver disease.ConclusionsLiver disease progression in people living with HIV/HBV appears to be linked to psychosocial/behavioural factors. More effective screening/management of coinfection and metabolic syndrome, as well as strategies for smoking cessation, should be included in clinical follow‐up.
ISSN:14783231
14783223
DOI:10.1111/liv.70191