Epidemiological Trends and CD4+T Cell Recovery in HIV-1 Patients With HCV/HBV Co-Infection: A Retrospective Cohort Study in Southwest China (2003-2024).

Co-infection with HIV and chronic viral hepatitis (HBV and HCV) contributes to increased morbidity and complicates treatment outcomes. However, in Southwest China, a high-burden region epidemiological data on HIV/HBV and HIV/HCV co-infection remain limited. We conducted a retrospective cohort study including 146 537 HIV-1 infected individuals in Guangxi from 2003 to 2024. We compared co-infection prevalence and risk factors in two time periods (before 2013 and after 2013). Logistic regression was used to identify risk factors for co-infection. CD4 + T cell recovery was analyzed using generalized estimating equation (GEE) models. The overall prevalence of HIV/HCV and HIV/HBV co-infection was 5.41% and 9.92%, respectively. HIV/HCV co-infection significantly declined from 9.69% before 2013% to 3.03% after 2013, especially among sexually transmitted cases. HIV/HBV co-infection remained relatively stable. Intravenous drug users (IDU), low education level, and age 30-49 years were major risk factors. Coinfected patients showed poorer CD4 + T cell recovery, especially those with HIV/HCV. HIV/HCV co-infection has decreased over time in Guangxi, while HIV/HBV remains prevalent. Co-infection negatively impacts immune recovery. Targeted prevention and early treatment strategies are needed, especially for high-risk populations such as IDUs.