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Multicenter Study
. 2014 Jun 1;66(2):197-205.
doi: 10.1097/QAI.0000000000000142.

HIV outcomes in Hepatitis B virus coinfected individuals on HAART

Helen M Chun  1 , Octavio Mesner, Chloe L Thio, Ionut Bebu, Grace Macalino, Brian K Agan, William P Bradley, Jennifer Malia, Sheila A Peel, Linda L Jagodzinski, Amy C Weintrob, Anuradha Ganesan, Mary Bavaro, Jason D Maguire, Michael L Landrum; Infectious Disease Clinical Research Program HIV Working Group
Affiliations
Multicenter Study

HIV outcomes in Hepatitis B virus coinfected individuals on HAART

Helen M Chun et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Understanding the impact of hepatitis B virus (HBV) coinfection on HIV outcomes in the highly active antiretroviral therapy (HAART) era continues to be a critical priority given the high prevalence of coinfection and the potential for impaired immunologic, virologic, and clinical recovery.

Methods: Participants from the US Military HIV Natural History Study with an HIV diagnosis on HAART and serologically confirmed HBV infection status at HAART initiation (HI) were classified into 4 HBV infection (HB) groups. HIV virologic, immunologic, and clinical outcomes were evaluated by HB status.

Results: Of 2536 HIV-positive HAART recipients, with HBV testing results available to determine HB status in the HI window, HB status at HI was classified as HB negative (n = 1505; 66%), resolved HB (n = 518; 23%), isolated hepatitis B core antigen (n = 139; 6%), or chronic HB (n = 131; 6%). HIV virologic suppression and failure at 6 months or 1 year were not significantly different by HB status. A significantly faster rate of increase in CD4 cell count during the period between 4 and 12 years was observed for chronic HB relative to HB negative. Chronic and resolved HB were associated with an increased risk of AIDS/death compared with HB-negative individuals (chronic HB-hazard ratio = 1.68, 95% confidence interval: 1.05 to 2.68; resolved HB-hazard ratio = 1.61, 95% confidence interval: 1.15 to 2.25).

Conclusions: HB status did not have a significant impact on HIV virologic outcomes, however, CD4 cell count reconstitution after HI and the risk of an AIDS event or death after HI may be associated with HB status.

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Conflict of interest statement

Potential conflicts of interest: none reported.

Figures

Figure 1
Figure 1
CD4 Count Reconstitution by HBV Status at HI CD4 trends determined using LOWESS (locally weighted scatter plot smoothing). Abbreviations: Negative, negative HBV infection; Chronic, chronic HBV infection; Isolated Core, isolated core HBV infection; Resolved, resolved HBV infection; HI, HAART initiation.
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