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Factors Associated with Hepatitis B and C Co-Infection among HIV-Infected Patients in Singapore, 2006–2017

by Chiaw Yee Choy 1,2, Li Wei Ang 1,3, Oon Tek Ng 1,2,4, Yee Sin Leo 1,2,4,5 and Chen Seong Wong 1,2,5,*
National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore 308422, Singapore
Department of Infectious Diseases, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
Public Health Group, Ministry of Health, Singapore, College of Medicine Building, 16 College Road, Singapore 169854, Singapore
Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore
Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2019, 4(2), 87;
Received: 26 February 2019 / Revised: 13 May 2019 / Accepted: 24 May 2019 / Published: 27 May 2019
(This article belongs to the Special Issue HIV and Co-Infections: Old and New Challenges)
Co-infection of hepatitis B virus (HBV) and hepatitis C virus (HCV) with human immunodeficiency virus (HIV) is associated with increased risk of hepatic complications and mortality. A retrospective study to estimate the proportion of HBV and HCV co-infections in Singapore was conducted using a clinical database. We included 3065 patients who were seen under the Clinical HIV Programme at the largest referral centre for HIV care between 2006 and 2017 and were tested for both HBV and HCV. Factors associated with HIV-HBV and HIV-HCV co-infections were determined using logistic regressions. The majority (86.3%) of HIV-infected patients were mono-infected, while 7.2% were co-infected with HBV, 6.0% with HCV, and 0.5% were co-infected with both HBV and HCV. The most common HCV genotype was GT1 (63%). Factors significantly associated with HBV co-infection in the multivariable model were: Aged 30–49 years and 50–69 years at HIV diagnosis, male gender, and HIV transmission through intravenous drug use (IDU). Independent factors associated with HCV co-infection were: Malay ethnicity, HIV transmission through IDU, and HIV diagnosis between 2006 and 2008. Behavioural risk factors such as IDU, as well as epidemiologic differences associated with co-infection, should inform further studies and interventions aimed at reducing viral hepatitis infection among HIV-infected individuals. View Full-Text
Keywords: HIV; hepatitis; HBV; HCV; co-infection; prevalence HIV; hepatitis; HBV; HCV; co-infection; prevalence
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Choy, C.Y.; Ang, L.W.; Ng, O.T.; Leo, Y.S.; Wong, C.S. Factors Associated with Hepatitis B and C Co-Infection among HIV-Infected Patients in Singapore, 2006–2017. Trop. Med. Infect. Dis. 2019, 4, 87.

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