HIV Outcomes in Hepatitis B Virus Coinfected Individuals on HAART

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 66; no. 2; pp. 197 - 205
• Main Authors: Chun, Helen M, Mesner, Octavio, Thio, Chloe L, Bebu, Ionut, Macalino, Grace, Agan, Brian K, Bradley, William P, Malia, Jennifer, Peel, Sheila A, Jagodzinski, Linda L, Weintrob, Amy C, Ganesan, Anuradha, Bavaro, Mary, Maguire, Jason D, Landrum, Michael L
• Format: Journal Article
• Language: English
• Published: United States by Lippincott Williams & Wilkins 01-06-2014; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Antigens; Antiretroviral drugs; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Coinfection - drug therapy; Coinfection - virology; Female; Follow-Up Studies; Hepatitis; Hepatitis B; Hepatitis B - complications; Hepatitis B - drug therapy; Hepatitis B Core Antigens - metabolism; HIV; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; Immunology; Logistic Models; Male; Prospective Studies; Risk assessment; Young Adult
• ISSN: 1525-4135; 1944-7884
• DOI: 10.1097/QAI.0000000000000142

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 interval1.05 to 2.68; resolved HB—hazard ratio = 1.61, 95% confidence interval1.15 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.