ARCHIVED - Infectious Diseases News Brief - January 25, 2013

New data highlight US hepatitis burden

Recent data highlight the chronic viral hepatitis burden in the United States, especially among baby boomers. Patients aged 44 to 63 years comprised 50% of all hepatitis B virus infections and 75% of all hepatitis C virus infections.  The Chronic Hepatitis Cohort Study was a prospective longitudinal, observational cohort study in which researchers reviewed the medical records of more than 1.6 million adults who were seen from 2006 to 2010. Among those, 2,202 had confirmed chronic HBV and 8,810 had confirmed chronic HCV.  In the cohort of patients with HBV infection, 57.8% were Asian/Pacific Islander, 28.3% were white and 13.3% were black. Most of the patients (76.3%) had private insurance, 16.5% had Medicare and 5.1% had Medicaid. From 2001 to 2010, 22.3% of patients had a liver biopsy, 37.9% were hospitalized at least once and 2.1% underwent liver transplant for end-stage liver disease. The death rate was 21.6 per 1,000 person-years.  Among patients with HCV infection, 69.5% were white, 22.7% were black and 5.9% were Asian/Pacific Islander. Most of the patients (61.8%) had private insurance, 12.1% had Medicaid and 22.9% had Medicare. From 2001 to 2010, 38.4% of patients had a liver biopsy and 44.3% had been hospitalized at least once. In addition, 4.7% of patients underwent liver transplant for end-stage liver disease. The death rate was 33 per 1,000 person-years. In this cohort, 28% of patients had also been tested for HIV, of whom 2.9% were positive.“The Chronic Hepatitis Cohort Study has already generated unique information about the high morbidity and mortality in this population,” the researchers wrote. “It is expected to yield much data-driven information about the impact of therapies, comorbidities and conditions on the general population with HBV and HCV in the future.”  The CDC recently recommended that all baby boomers, those born between 1945 and 1965, receive a one-time test for HCV.

Source: Healio Infectious Disease News January 23, 2013

Stopping Smoking Reduces Risk of Bacterial Pneumonia in People With HIV

Bacterial pneumonia is one of the commonest and most serious infections occurring in people infected with HIV.  A metanalysis of cohort and case control studies published in BioMed Central’s open access journal BMC Medicine finds that current smokers with HIV were at double the risk of bacterial pneumonia than non-smoking counterparts, but that when people stopped smoking their risk was reduced. The metanalysis reanalysed the data of several thousand participants with HIV, from 14 studies based in USA, Europe and South Africa. Overall it appeared that current smoking was associated with a 70-100% increase in risk of bacterial pneumonia, compared to non-smokers, but that stopping smoking decreased this by about a third. This was independent of CD4 count or antiretroviral therapy.  Prof Paul Aveyard, from University of Oxford who led the study explained that, “Antiretroviral treatment means that people with HIV can have a normal life expectancy. However they still have substantially increased health risks compared to the general population, including risk of pneumonia. Our results show that smokers with HIV have twice the risk of bacterial pneumonia, but that stopping smoking can reduce this risk. In order to prevent this potentially life threatening lung disease we believe that smoking cessation programs should be promoted as part of HIV treatment.”

Source: Science Daily News January 22, 2013