Background: Hepatitis B, C and D virus infection is frequent in HIV-infected individuals, particularly in drug addicts. However, chronic liver disease of viral etiology has been little studied in AIDS.
Methods: The impact of infection by hepatotropic viruses on hospital morbidity/mortality was analyzed in a group of HIV positive (HIV+) patients over the period from October 1991 to April 1994.
Results: Viral liver disease was the cause of hospitalization in 94 (8.6%) out of 1,082 HIV+ patient admissions. Only 4 admissions were for severe or fulminant cases of acute viral hepatitis. Complicated (gastrointestinal bleeding, and spontaneous bacterial infection) or decompensated (ascites, jaundice and encephalopathy) viral liver disease was the diagnosis in the 90 remaining cases. Death directly associated to liver diseases was observed in 9 (9.5%) of these patients, globally representing 4.3% (9 out of 207) of the causes of hospital mortality during the study period, and the fifth in order of frequency. Hospital stay was significantly longer in patients admitted for decompensated or complicated chronic viral liver disease in comparison with the remaining patients (27.9 +/- 9 versus 18.4 +/- 8 days) (p < 0.05). Infection by the hepatitis C virus was observed in 88% (80 out of 90) of the hospital admissions for chronic liver disease although half presented coinfection by B or delta viruses.
Conclusions: Chronic liver disease of viral etiology, mainly by the hepatitis C virus, represents an important cause of hospital morbidity and mortality in Spanish HIV+ patients.