{
  "abstract": "BackgroundHIV/HBV coinfection is associated with substantial liver-related morbidity and mortality, yet the impact of social vulnerability (SV) on clinical outcomes has not been systematically assessed. We evaluated associations of multidimensional SV with mortality, hepatic, virologic, and extrahepatic organ outcomes among adults with HIV/HBV.\n\nMethodsWe conducted a retrospective cohort study using TriNetX data from 110 U.S. healthcare organizations (2010-2026). We propensity score matched adults with HIV/HBV with and without documented SV 1:1 (2,024 per group). SV was defined using a four-domain framework encompassing material, healthcare access and engagement, interpersonal, and psychosocial vulnerability.\n\nResultsOver 15,900 person-years, SV was associated with higher mortality (hazard ratio [HR], 2.06; 95% confidence interval [CI], 1.72-2.47), liver composite events (HR, 1.37; 95% CI, 1.07-1.76), hepatic decompensation (HR, 1.94; 95% CI, 1.39-2.70), hepatic failure (HR, 2.39; 95% CI, 1.53-3.73), HBV viremia (HR, 1.69; 95% CI, 1.32-2.16), and HIV viremia (HR, 2.05; 95% CI, 1.71-2.46). SV was also associated with major adverse cardiovascular events (HR, 1.47), chronic kidney disease (HR, 1.49), and diabetes (HR, 1.25). Multidomain SV generally showed stronger associations than single-domain SV for most hepatic and virologic outcomes, with HR ranges of 1.76-2.62 versus 1.35-1.76 for single-domain SV. Healthcare access and engagement vulnerability was most consistently associated with mortality and hepatic outcomes.\n\nConclusionsSV was associated with mortality, hepatic disease, impaired HIV/HBV control, extrahepatic organ morbidity, and acute care utilization in adults with HIV/HBV. SV assessment may improve risk stratification and identify actionable intervention targets during HIV/HBV care.\n\nGraphical abstract\n\nO_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=110 SRC=\"FIGDIR/small/26361853v1_ufig1.gif\" ALT=\"Figure 1\"> View larger version (35K): org.highwire.dtl.DTLVardef@438ef4org.highwire.dtl.DTLVardef@15e4ad9org.highwire.dtl.DTLVardef@18409fborg.highwire.dtl.DTLVardef@1ab6db4_HPS_FORMAT_FIGEXP M_FIG C_FIG",
  "abstract_shown": true,
  "affiliations": [
    "Case Western Reserve University"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "G. Yendewa"
    },
    {
      "name": "T. Chengsupanimit"
    },
    {
      "name": "A. Dehghani"
    },
    {
      "name": "A. Ahmed"
    },
    {
      "name": "A. Mohareb"
    },
    {
      "name": "C. Cohen"
    },
    {
      "name": "M. Freeman"
    },
    {
      "name": "H. N. Kim"
    },
    {
      "name": "I. Ofotokun"
    },
    {
      "name": "K. Dube"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7qpavqek80rdv.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.31.26361853",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361853v1.full",
  "id": "7qpavqek80rdv",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361853v1",
  "language": null,
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "hiv aids"
    ],
    [
      "openalex",
      "2713|Hepatitis B Virus Studies"
    ]
  ],
  "openalex": "W7206184034",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361853v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7qpavqek80rdv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "10.64898/2026.08.31.26361853",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361853v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:hiv aids",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Multidimensional Social Vulnerability and Hepatic and Extrahepatic Outcomes in Adults With HIV/HBV Coinfection in the United States",
  "title_text": "Multidimensional Social Vulnerability and Hepatic and Extrahepatic Outcomes in Adults With HIV/HBV Coinfection in the United States",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/7qpavqek80rdv",
  "venue": "medRxiv",
  "versions": []
}