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A new 10-year regional study led by CUNY SPH doctoral graduate Thinh Toan Vu reveals that adults living with both HIV and hepatitis B virus across the Asia-Pacific face substantially higher risks of kidney dysfunction than those living with HIV alone.
Drawing on data from more than 23,000 adults enrolled in the TREAT Asia Observational Database – Low Intensity TransfEr (TAHOD-LITE) cohort across seven countries and territories from 2010 to 2021, the study found that 14.8% of people with HIV and hepatitis B developed kidney dysfunction (eGFR<60mL/min/1.73m2), nearly double the 7.6% seen in those without hepatitis B co-infection. After adjusting for demographics, individuals with HIV and hepatitis B co-infection had 1.66 times higher odds of developing kidney dysfunction.
“This study is one of the largest and most comprehensive assessments of kidney dysfunction in people with HIV and hepatitis B in the Asia-Pacific, and our findings show that hepatitis B co-infection significantly amplifies the risk of kidney dysfunction in people living with HIV,” says Dr. Vu. “This highlights a critical need for earlier and more frequent kidney monitoring, particularly in resource-limited settings where kidney disease often goes undetected until it is advanced.”
The research team identified several factors associated with increased risk of kidney dysfunction among people with HIV and hepatitis B, including older age, low platelet and CD4 counts, and residence in upper-middle-income countries. Adults aged 50 or older experienced more than sixfold greater risk of renal impairment compared with those aged 18–29. Higher CD4 counts substantially reduced the likelihood of kidney dysfunction. The study also found differences in risk by antiretroviral therapy regimen: individuals receiving NRTI+NNRTI or NRTI+PI had lower risk compared to those on NRTI+INSTI. No significant difference was observed between TDF and TAF, though the sample size for TAF was limited.
“Many countries in the Asia-Pacific still rely heavily on TDF because it is cost-effective and widely accessible for both HIV and hepatitis B treatment,” says Dr. Vu. “Because these medications are so central to care in the region, understanding their long-term impact on kidney health, especially for those with dual infection, is essential for ensuring safe and effective treatment.”
This study was presented at the 13th International AIDS Society Conference on HIV Science 2025 in Kigali, Rwanda, and is part of the Fogarty-IeDEA Mentorship Program (FIMP).
