Table 2.
Incidence Rates and Hazard Ratios for Mortality, Hepatic, Virologic, and Multisystem Outcomes by Social Vulnerability Status in Propensity Score-Matched Adults With HIV/HBV Coinfection
| Outcomes | Cohorts | IR (95% CI) (per 100 person-years) | HR (95% CI) | p-Value | |||
|---|---|---|---|---|---|---|---|
| At risk | SV | No SV | SV | No SV | |||
| Follow up, Mean ± SD (years) | 3.95 ± 3.72 | 3.34 ± 3.37 | 4.57 ± 4.06 | ||||
| Follow up, Median (IQR) (years) | 2.86 (5.25) | 2.18 (4.32) | 3.54 (6.17) | ||||
| Survival | |||||||
| All-cause mortality | 4,031 | 316 (15.7%) | 195 (9.7%) | 4.7 (4.2–5.2) | 2.1 (1.8–2.4) | 2.06 (1.72–2.47) | <0.001 |
| Liver disease | |||||||
| Liver composite | 3,593 | 131 (7.4%) | 126 (6.9%) | 2.2 (1.9–2.6) | 1.5 (1.3–1.8) | 1.37 (1.07–1.76) | 0.011 |
| Cirrhosis | 3,765 | 75 (4.0%) | 84 (4.4%) | 1.2 (1.0–1.5) | 1.0 (0.8–1.2) | 1.21 (0.88–1.65) | 0.244 |
| Hepatic decompensation | 3,828 | 89 (4.7%) | 59 (3.0%) | 1.4 (1.1–1.7) | 0.7 (0.5–0.9) | 1.94 (1.39–2.70) | <0.001 |
| Hepatic failure | 3,910 | 56 (2.9%) | 30 (1.5%) | 0.9 (0.7–1.1) | 0.3 (0.2–0.5) | 2.39 (1.53–3.73) | <0.001 |
| HCC | 3,992 | 16 (0.8%) | 19 (1.0%) | 0.2 (0.1–0.4) | 0.2 (0.1–0.3) | 1.04 (0.53–2.03) | 0.905 |
| HBV viremia and liver inflammation | |||||||
| HBV DNA ≥2,000 IU/mL | 3,782 | 151 (8.2%) | 114 (5.9%) | 2.5 (2.1–2.9) | 1.3 (1.1–1.6) | 1.69 (1.32–2.16) | <0.001 |
| Significant ALT elevation (≥100 IU/L) | 2,898 | 186 (13.5%) | 192 (12.7%) | 4.0 (3.5–4.7) | 2.8 (2.4–3.2) | 1.32 (1.08–1.62) | 0.007 |
| Significant AST elevation (≥100 IU/L) | 2,407 | 239 (22.9%) | 263 (19.3%) | 6.9 (6.0–7.8) | 4.2 (3.7–4.8) | 1.50 (1.26–1.79) | <0.001 |
| Liver synthetic function | |||||||
| Thrombocytopenia (platelet count <150 ×109/L) | 2,397 | 204 (18.9%) | 233 (17.7%) | 5.7 (4.9–6.5) | 3.9 (3.4–4.4) | 1.29 (1.07–1.56) | 0.008 |
| Hypoalbuminemia (albumin <3.5 g/dL) | 2,236 | 234 (24.9%) | 273 (21.1%) | 7.5 (6.6–8.5) | 4.6 (4.1–5.2) | 1.48 (1.24–1.77) | <0.001 |
| Coagulopathy (INR >1.5) | 3,308 | 111 (6.9%) | 104 (6.2%) | 2.0 (1.7–2.4) | 1.4 (1.2–1.7) | 1.35 (1.03–1.76) | 0.024 |
| HIV disease control | |||||||
| HIV RNA >50 copies/mL | 2,370 | 243 (25.0%) | 234 (16.7%) | 7.5 (6.6–8.5) | 3.7 (3.2–4.2) | 2.05 (1.71–2.46) | <0.001 |
| CD4 count <200 cells/μL | 2,647 | 172 (15.3%) | 177 (11.6%) | 4.6 (3.9–5.3) | 2.5 (2.2–2.9) | 1.58 (1.28–1.95) | <0.001 |
| Extrahepatic outcomes | |||||||
| MACE | 3,092 | 224 (15.3%) | 222 (13.7%) | 4.6 (4.0–5.2) | 3.0 (2.6–3.4) | 1.47 (1.22–1.77) | <0.001 |
| Ischemic heart disease | 3,238 | 166 (10.7%) | 146 (8.6%) | 3.2 (2.7–3.7) | 1.9 (1.6–2.2) | 1.61 (1.29–2.02) | <0.001 |
| Heart failure | 3,435 | 126 (7.6%) | 86 (4.9%) | 2.3 (1.9–2.7) | 1.1 (0.9–1.4) | 1.99 (1.51–2.62) | <0.001 |
| Cerebrovascular disease | 3,443 | 139 (8.3%) | 112 (6.4%) | 2.5 (2.1–2.9) | 1.4 (1.2–1.7) | 1.67 (1.30–2.15) | <0.001 |
| CKD | 2,885 | 164 (12.2%) | 158 (10.2%) | 3.7 (3.1–4.3) | 2.2 (1.9–2.6) | 1.49 (1.20–1.86) | <0.001 |
| Diabetes | 2,816 | 234 (17.2%) | 258 (17.7%) | 5.2 (4.6–5.9) | 3.9 (3.4–4.4) | 1.25 (1.04–1.49) | 0.015 |
Hazard ratios compare adults with HIV/HBV coinfection with versus without documented social vulnerability after propensity score matching. Outcome-specific analytic cohort, n, indicates the number at risk for each outcome after exclusion of individuals with pre-follow-up evidence of that outcome; therefore, denominators vary across rows. Incidence rates are per 100 person-years. Significant ALT and AST elevations were defined as ≥3× upper limit of normal or ≥100 U/L. ALT indicates alanine aminotransferase; AST, aspartate aminotransferase; MACE, major adverse cardiovascular events; HCC, hepatocellular carcinoma; CKD, chronic kidney disease; INR, international normalized ratio; IR, incidence rate; SV, social vulnerability.