Background: Among persons living with HIV/AIDS (PLWHA), coinfection with chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) can lead to severe liver-related morbidity and mortality. Surveillance data on HIV coinfection with HBV and HCV are not routinely collected.
Methods: Chronic HBV and HCV cases were matched to the California Office of AIDS Enhanced HIV/AIDS Reporting System registry using a probabilistic algorithm including first and last names, birthdate, sex, race, and social security number. Risk ratios were calculated to compare persons coinfected with HBV or HCV and HIV to those only infected with HIV (monoinfected), stratified by demographic and risk characteristics.
Results: At the end of 2011 there were 120,921 PLWHA, 231,888 persons ever reported with chronic HBV, and 516,814 persons ever reported with chronic HCV in California. Overall, 5% of PLWHA were coinfected with HBV (5% male and 2% female) and 12% were coinfected with HCV (12% male and 14% female). HBV coinfected persons were 1.8 times as likely as HIV monoinfected persons to be Asian/Pacific Islander. HCV coinfected persons were more likely than monoinfected persons to be 55-64 years old or American Indian/Alaska Native, especially among females. Among HCV coinfected persons, heterosexual transmission in females (RR=0.4), and male sexual contact in males (RR=0.6), were less common HIV risk factors than among monoinfected persons. Correspondingly, injection drug use (IDU) as a HIV risk factor was 5.2 times more common among HCV coinfected males and 4.1 times more common among HCV coinfected females compared to monoinfected persons.
Conclusions: Coinfected persons have risk factors consistent with known risk factors for HBV and HCV such as IDU; however, key differences between coinfected and monoinfected populations exist. Given the consequences of coinfection, PLWHA with ongoing risk should be tested regularly for HCV, vaccinated against HBV, and counseled on reducing viral hepatitis risk.