A Comparison of Hepatitis B Virus Infection in HIV-infected and HIV-uninfected Participants Enrolled in a Multi-National Clinical Trial: HPTN 052.

Publication Type:

Journal Article

Source:

Journal of acquired immune deficiency syndromes (1999) (2017)

Abstract:

OBJECTIVE: Data comparing hepatitis B virus (HBV) infection in HIV-infected [HIV(+)], and HIV-uninfected [HIV(-)] individuals recruited into the same study are limited. HBV infection status and chronic hepatitis B (cHB) were characterized in a multi-national clinical trial: HIV Prevention Trials Network (HPTN 052).

METHOD: HBV infection status at enrollment was compared between HIV(+) (N=1241) and HIV(-) (N=1232) from seven HBV-endemic countries. Hepatitis B e antigen (HBeAg) and plasma HBV DNA were determined in cHB. Median CD4, median plasma HIV RNA, and prevalence of transaminase elevation were compared in HIV(+) with and without cHB. Significance was assessed with Chi-square, Fisher's exact, and median tests.

RESULTS: Among all participants, 33.6% had HBV exposure without cHB (8.9% isolated HBV core antibody, 'HBcAb'; 24.7% HBcAb and anti-HB surface antibody positive, "recovered"), 4.3% had cHB, 8.9% were vaccinated, and 53.5% were uninfected. Data were similar among HIV(+) and HIV(-) except for isolated HBV core antibody (HBcAb), which was more prevalent in HIV(+) than HIV(-) [10.1% vs. 7.7%, P=0.046]. Median HBV DNA trended higher in HIV(+) than in HIV(-). In HIV(+) with cHB versus those without cHB, transaminase elevations were more prevalent (ALT ≤ Grade 2, 12% vs. 5.2%, P=0.037; AST ≤ Grade 2, 26% vs. 6.0%, P<0.001), CD4 trended lower, and HIV RNA was similar.

CONCLUSIONS: HBV infection status did not differ by HIV infection status. HIV co-infection was associated with isolated HBcAb and a trend of increased HBV DNA. In HIV, cHB was associated with mild transaminase elevations and a trend toward lower CD4.