Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Patrick Williams

Abstract

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis leads to unfavorable health outcomes, making treatment of HIV difficult and increasing the odds of HIV transmission. The purpose of this study is to assess whether viral hepatitis (B and C) hinders HIV viral suppression and impacts the white blood cell count (CD4) when a person is concurrently infected with both viruses. The syndemics theory guided this study. Two research questions tested whether there was an association between coinfection with viral hepatitis and HIV viral load suppression. The research design was quantitative case-control with secondary data from 65,626 reports of HIV, HBV, and HCV at the Georgia Department of Public Health. Descriptive statistics and measures of association indicated that a coinfection with HBV or HCV was determined to be significantly associated with HIV viral load suppression. Persons coinfected with HBV/HIV were 1.45 times more likely to have achieved HIV viral load suppression than persons who were only infected with HIV (OR= 1.45, 95% CI 1.32-1.59, p= .0001). Those coinfected with HCV/HIV were 1.55 times more likely to have achieved HIV viral load suppression than those only infected with HIV (OR= 1.55, 95% CI 1.44-1.67, p=.0001). Coinfection with HBV was found to have a greater impact on CD4 cell counts, making persons infected with HBV/HIV 1.45 times more likely to be AIDS defining than HCV in individuals infected with HIV (OR= 1.45, 95% CI 1.34-1.67, p= .0001). Positive social change implications may include use of findings to support future prevention and control strategies in the coinfected population aimed at decreasing or controlling the spread of HIV and other sexually transmitted infections in the United States.

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