# Epidemiologic Characteristics of Chronic Hepatitis B and Coinfections with Hepatitis C Virus or Human Immunodeficiency Virus in South Korea: A Nationwide Claims-Based Study Using the Korean Health Insurance Review and Assessment Service Database

## TL;DR

This study examines the prevalence and health outcomes of chronic hepatitis B and coinfections with HCV or HIV in South Korea using nationwide health insurance data.

## Contribution

The study provides the first nationwide analysis of HBV coinfections in South Korea using claims data, revealing distinct epidemiological patterns and health disparities.

## Key findings

- HBV/HCV coinfection was associated with higher rates of hypertension, diabetes, and liver complications like hepatocellular carcinoma.
- HBV/HIV coinfection was more common in younger males and linked to higher dyslipidemia rates.
- HBV antiviral use increased over time across all groups, indicating improved treatment access.

## Abstract

Coinfections with hepatitis C virus (HCV) or human immunodeficiency virus (HIV) among individuals with chronic hepatitis B (CHB) are associated with worse clinical outcomes but remain understudied due to their low prevalence and the sensitivity of associated data. This nationwide, cross-sectional study utilized claims data from the Korean Health Insurance Review and Assessment Service (2014–2021) to investigate the prevalence, comorbidities, treatment patterns, and liver-related complications among patients with HBV monoinfection, HBV/HIV, HBV/HCV, or triple coinfection. Among over 4.5 million patients with chronic hepatitis B, the prevalence of HIV and HCV coinfection ranged from 0.05 to 0.07% and 0.77 to 1.00%, respectively. Patients with HBV/HCV coinfection were older and had significantly higher rates of hypertension, diabetes, dyslipidemia, and major adverse liver outcomes, including hepatocellular carcinoma and liver transplantation, compared to other groups. HBV/HIV coinfection was more common in younger males and was associated with higher dyslipidemia. The use of HBV antivirals increased over time across all groups. These findings highlight the distinct clinical characteristics and unmet needs of coinfected populations, underscoring the importance of tailored screening and management strategies in HBV-endemic settings.