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. 2008 Sep;43(1):32-6.
doi: 10.1016/j.jcv.2008.03.030. Epub 2008 May 16.

Incidence of transaminitis among HIV-infected patients with occult hepatitis B

Vincent Lo Re 3rd  1 , Benjamin Wertheimer, A Russell Localio, Jay R Kostman, Janel Dockter, Jeffrey M Linnen, Cristina Giachetti, Zachariah Dorey-Stein, Ian Frank, Brian L Strom, Robert Gross
Affiliations

Incidence of transaminitis among HIV-infected patients with occult hepatitis B

Vincent Lo Re 3rd et al. J Clin Virol. 2008 Sep.

Abstract

Background: The clinical significance of occult hepatitis B virus (HBV) infection, defined as the presence of HBV DNA in individuals with HBV core antibodies (anti-HBc) in the absence of HBV surface antigen (HBsAg), is unclear in HIV-infected patients. This information is needed to determine the importance of detecting and treating occult HBV in this population.

Objective: To determine if HIV-infected patients with occult HBV infection have an increased incidence of transaminitis.

Study design: We performed a cohort study among randomly selected HBsAg-/anti-HBc+ HIV-infected patients in the Penn CFAR Database and Specimen Repository. HBV DNA was qualitatively detected using a transcription-mediated amplification assay. Hepatic transaminase levels, the main study outcome, were collected at 6-month intervals from the time of occult HBV determination.

Results: Among 97 randomly selected subjects without baseline transaminitis, 13 (13%) had occult HBV. These subjects more frequently had detectable HIV RNA. The 2-year incidence of transaminitis among HIV-infected subjects with occult HBV (50 events/100 person-years) was not significantly different from those without occult HBV (38 events/100 person-years; adjusted incidence rate ratio=1.36 [95% CI, 0.72-2.59]).

Conclusions: Occult HBV did not increase the incidence of hepatic transaminitis over 2 years. Future studies should determine whether occult HBV is associated with other clinically important outcomes, particularly hepatocellular carcinoma.

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