Epidemiology, Economic Burden, and Risk Factors of Chronic Viral Diseases

摘要

OBJECTIVE: To outline the epidemiology of the human immunodeficiency virus (HIV) and hepatitis B virus (HBV) epidemics and their economic burden. SUMMARY: The global epidemics of HIV infection (40 million) and HBV infection (400 million) overlap so that approximately 4 million individuals worldwide are co-infected with HIV and HBV. Generally about 5%-10% of HIV-infected individuals are co-infected with HBV, but the numbers depend on the specific patient population.In the most recent published comparison of costs of treating chronic viral infections, HIV accounts for higher medical expenses than HBV. The overall costs of treating HIV in the United States in 1997 were about Dollars 4.5 billion (in 1997 U.S. dollars), while the overall cost for treating hepatitis B in 1997 was Dollars 51.4 million. However, HBV complications are expensive. Treatment options for HIV and HBV have evolved differently. In HIV treatment, the high pill burden and dietary restriction of early highly active antiretroviral therapy (HAART) have been replaced with simpler more potent combination regimens that combine several agents in a single oral dose taken once or twice daily. For HBV infection, the issues are somewhat different: sequential monotherapy rather than combination therapy is the usual management approach. A substantial number of individuals are co-infected with HIV and hepatitis viruses, including HBV, which complicates clinical management because some antiviral agents have activity against both HIV and HBV.