Kanwal F (VA Greater Los Angeles Healthcare System, Los Angeles, CA)
Gralnek IM (VA Greater Los Angeles Healthcare System, Los Angeles, CA)
Hays RD (RAND Health Sciences Program, Santa Monica)
Dulai GS (VA Greater Los Angeles Healthcare System, Los Angeles, CA)
Spiegel BM (VA Greater Los Angeles Healthcare System, Los Angeles, CA)
Asch S (VA Greater Los Angeles Healthcare System, Los Angeles, CA)
Chronic viral hepatitis in HIV infected patients has emerged as a significant health problem within the VA healthcare system. However, little is known about the health burden of chronic viral hepatitis in HIV infected patients. We compared health related quality of life (HRQOL) of patients with HIV and hepatitis C virus (HCV) or HIV and hepatitis B virus (HBV) co-infection to those with HIV mono-infection.
Using a nationally representative sample of 1,874 adults with HIV who completed a baseline and 2 follow-up interviews, we identified those with HIV mono-infection (n = 1,493), HIV-HCV co-infection (n=279) and HIV-HBV co-infection (n=122). After weighting for population prevalence and non-response, we estimated the number of co-infected patients under care in the United States. We then measured baseline and change over time scores for physical and mental health (PHS, MHS), overall quality of life (QOL), overall health, and disability days. To identify the independent effect of co-infection, we adjusted for demographic and clinical predictors of HRQOL using multivariable regression.
We estimated that there were 31,906 patients with HIV-HCV co-infection, 13,558 with HIV-HBV co-infection, and 213,642 with HIV mono-infection. Despite significant differences in socio-demographic characteristics between groups, there were no differences in the baseline or change scores for PHS, MHS, overall QOL, overall health, or disability days between groups.
. In conclusion, we found no significant differences in disease burden as assessed by a generic HRQOL instrument between patients with HIV mono-infection and HIV-HCV or HIV-HBV co-infection.
These data are generalizable to the veterans with HIV and chronic viral hepatitis co-infection and are relevant in counseling co-infected veterans regarding the impact of co-infection on HRQOL. These data are also be important in designing clinical trials and conducting cost-effectiveness analyses including this vulnerable cohort.