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. 2012 Jan 15;205(2):185-93.
doi: 10.1093/infdis/jir720. Epub 2011 Dec 5.

Hepatitis B virus coinfection negatively impacts HIV outcomes in HIV seroconverters

Helen M Chun  1 , Mollie P Roediger, Katherine Huppler Hullsiek, Chloe L Thio, Brian K Agan, William P Bradley, Sheila A Peel, Linda L Jagodzinski, Amy C Weintrob, Anuradha Ganesan, Glenn Wortmann, Nancy F Crum-Cianflone, Jason D Maguire, Michael L Landrum; Infectious Disease Clinical Research Program HIV Working Group
Collaborators, Affiliations

Hepatitis B virus coinfection negatively impacts HIV outcomes in HIV seroconverters

Helen M Chun et al. J Infect Dis. .

Abstract

Background: Understanding the impact of hepatitis B virus (HBV) in human immunodeficiency virus (HIV) coinfection has been limited by heterogeneity of HIV disease. We evaluated HBV coinfection and HIV-related disease progression in a cohort of HIV seroconverters.

Methods: Participants with HIV diagnosis seroconversion window of ≤ 3 years and serologically confirmed HBV infection (HB) status were classified at baseline into 4 HB groups. The risk of clinical AIDS/death in HIV seroconverters was calculated by HB status.

Results: Of 2352 HIV seroconverters, 474 (20%) had resolved HB, 82 (3%) had isolated total antibody to hepatitis B core antigen (HBcAb), and 64 (3%) had chronic HB. Unadjusted rates (95% confidence intervals [CIs]) of clinical AIDS/death for the HB-negative, resolved HB, isolated HBcAb, and chronic HB groups were 2.43 (2.15-2.71); 3.27 (2.71-3.84); 3.75 (2.25-5.25); and 5.41 (3.41-7.42), respectively. The multivariable risk of clinical AIDS/death was significantly higher in the chronic HB group compared to the HB-negative group (hazard ratio [HR], 1.80; 95% CI, 1.20-2.69); while the HRs were increased but nonsignificant for those with resolved HB (HR, 1.17; 95% CI, .94-1.46) and isolated HBcAb (HR, 1.14; 95% CI, .75-1.75).

Conclusions: HBV coinfection has a significant impact on HIV outcomes. The hazard for an AIDS or death event is almost double for those with chronic HB compared, with HIV-monoinfected persons.

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Figures

Figure 1.
Figure 1.
AIDS or death events by hepatitis B virus infection (HB) status at seroconversion. The number of participants at risk of an AIDS or death event are provided for each HB group. Abbreviation: HBcAb, total antibody to hepatitis B core antigen.
Figure 2.
Figure 2.
Risk of AIDS or death events by HB infection status at HIV seroconversion.
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