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Author Notes:

Correspondence: E-mail: mlandrum@idcrp.org

See publication for full list of author contributions.

The authors would like to thank Mr. William Bradley for his expertise and assistance with the U.S. Military HIV Natural History Study (NHS) database.

We would also like to express our gratitude for the current members of the IDCRP HIV Working Group and the long line of military HIV researchers who have supported the HIV NHS, and for the research coordinators and support staff for their countless hours of work.

Most importantly, we would like to thank the patients for their participation, without which this research would not have been possible.

The content of this publication is the sole responsibility of the authors and does not necessarily reflect the views or policies of the NIH or the Department of Health and Human Services, the DoD or the Departments of the Army, Navy or Air Force.

Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government.

The analyses, conclusions and decision to submit the manuscript are the independent work and decision of the authors.

The NIH had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors have declared that no competing interests exist.

Subjects:

Research Funding:

Support for this work (IDCRP#G187YS-RV198) was provided by the Infectious Disease Clinical Research Program (IDCRP, www.idcrp.org), a Department of Defense (DoD) program executed through the Uniformed Services University of the Health Sciences.

This project has been funded in whole, or in part, with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), under Inter-Agency Agreement Y1-AI-5072.

The IDCRP reviewed the study design, collected the data, and provided salary support to investigators (M.L.L. A.M.F., N.F.C., A.C.W., A.G., and B.K.A.).

Keywords:

  • Science & Technology
  • Multidisciplinary Sciences
  • Science & Technology - Other Topics
  • ACTIVE ANTIRETROVIRAL THERAPY
  • T-CELL RESPONSES
  • NATURAL-HISTORY
  • HBV INFECTION
  • HIV-INFECTION
  • SEROCONVERSION
  • RECOMMENDATIONS
  • COINFECTION
  • MANAGEMENT
  • MORTALITY
  • HIV diagnosis and management
  • Hepatitis B virus
  • Highly-active antiretroviral therapy
  • HIV infections
  • Serology
  • Antiretroviral therapy
  • Immune response
  • Serodiagnosis

The Effect of Human Immunodeficiency Virus on Hepatitis B Virus Serologic Status in Co-Infected Adults

Tools:

Journal Title:

PLoS ONE

Volume:

Volume 5, Number 1

Publisher:

, Pages e8687-e8687

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: Factors associated with serologic hepatitis B virus (HBV) outcomes in HIV-infected individuals remain incompletely understood, yet such knowledge may lead to improvements in the prevention and treatment of chronic HBV infection. Methods and Findings: HBV-HIV co-infected cohort participants were retrospectively analyzed. HBV serologic outcomes were classified as chronic, resolved, and isolated-HBcAb. Chronic HBV (CHBV) was defined as the presence of HBsAg on two or more occasions at least six months apart. Risk factors for HBV serologic outcome were assessed using logistic regression. Of 2037 participants with HBV infection, 281 (14%) had CHBV. Overall the proportions of HBV infections classified as CHBV were 11%, 16%, and 19% for CD4 cell count strata of ≥500, 200-499, and < 200, respectively (p < 0.0001). Risk of CHBV was increased for those with HBV infection occurring after HIV diagnosis (OR 2.62; 95% CI 1.78-3.85). This included the subset with CD4 count ≥500 cells/mL where 21% of those with HBV after HIV diagnosis had CHBV compared with 9% for all other cases of HBV infection in this stratum (p = 0.0004). Prior receipt of HAART was associated with improved HBV serologic outcome overall (p = 0.012), and specifically among those with HBV after HIV (p = 0.002). In those with HBV after HIV, HAART was associated with reduced risk of CHBV overall (OR 0.18; 95% CI 0.04-0.79); including reduced risk in the subsets with CD4 ≥350 cells/mL (p < 0.001) and CD4 ≥500 cells/μL (p = 0.01) where no cases of CHBV were seen in those with a recent history of HAART use. Conclusions: Clinical indicators of immunologic status in HIV-infected individuals, such as CD4 cell count, are associated with HBV serologic outcome. These data suggest that immunologic preservation through the increased use of HAART to improve functional anti-HBV immunity, whether by improved access to care or earlier initiation of therapy, would likely improve HBV infection outcomes in HIV-infected individuals.

Copyright information:

This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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