Outcome of hepatitis B virus infection in homosexual men and its relation to prior human immunodeficiency virus infection.
To investigate the effect of human immunodeficiency virus type 1 (HIV-1) infection on subsequent hepatitis B virus (HBV) infection, HIV antibody was sought in homosexual men who developed HBV infection during a hepatitis B vaccine trial. Among 134 unvaccinated HIV-1-negative men, 7% became HBV carriers, 64% had viremia, and 42% had clinical illness. Among vaccinated HIV-1-negative men, HBV infection severity decreased with number of vaccine doses administered. When adjusted for prior hepatitis B vaccination status, persons with HIV-1 infection preceding HBV infection had a significantly higher risk of developing HBV carriage, viremia, prolonged ALT elevation, and clinical illness. Among HIV-1-infected men, the risk of HBV carriage was increased in unvaccinated persons (21%) and those who failed to respond to vaccination (31%) and further increased in those who received vaccine doses at the time they developed new HBV infection (56%-80%), suggesting inactivated hepatitis B vaccine may temporarily impair the immune response to HBV infection in HIV-1-infected persons. HIV-1 infection was also associated with reduced alanine aminotransferase elevations during the first 36 months of follow-up of men who became HBV carriers.
Hadler
S C
SC
Division of Viral and Rickettsial Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
Judson
F N
FN
O'Malley
P M
PM
Altman
N L
NL
Penley
K
K
Buchbinder
S
S
Schable
C A
CA
Coleman
P J
PJ
Ostrow
D N
DN
Francis
D P
DP
D000410:Alanine Transaminase / Q000097:blood; D002353:Carrier State / Q000276:immunology; D004311:Double-Blind Method; D015483:HIV Antibodies / Q000032:analysis; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D015497:HIV-1; D006509:Hepatitis B / Q000150:complications* / Q000201:enzymology / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines; D006716:Homosexuality; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D014761:Viral Hepatitis Vaccines
D015483:HIV Antibodies; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D014761:Viral Hepatitis Vaccines; D000410:Alanine Transaminase