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)

ABSTRACT 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.