The effect of concurrent human immunodeficiency virus infection on chronic hepatitis B: a study of 150 homosexual men.
To determine the influence of concurrent human immunodeficiency virus (HIV) infection on chronic hepatitis B virus (HBV) infection, 150 male homosexual chronic hepatitis B surface antigen (HBsAg) carriers were studied. Of these, 82 subjects (55%) tested positive for antibodies to HIV. They were more likely to express hepatitis B "e" antigen (HBeAg) (P less than .001) and HBV-DNA (P less than .0005) in serum than were HIV-seronegative individuals. However, the degree of immune suppression did not influence HBeAg-HBV-DNA expression. In HBeAg-seropositive subjects, concurrent HIV infection was associated with lower serum alanine transferase levels (P less than .001). This effect increased with the degree of immune suppression as determined by CD4+ lymphocyte counts. Conversely, in patients negative for HBeAg, there was a weak trend towards higher alanine transferase levels with concurrent HIV. This study suggests that chronic hepatitis B may be less severe when accompanied by HIV infection; however, greater viral replication may make it more contagious and resistant to antiviral therapy. These data support an immune-mediated pathogenesis for hepatitis B and have implications for its control.
Bodsworth
N
N
Department of Public Health, University of Sydney, NSW Australia.
Donovan
B
B
Nightingale
B N
BN
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015704:CD4 Antigens / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004261:DNA Replication; D004279:DNA, Viral / Q000032:analysis; D015483:HIV Antibodies / Q000032:analysis; D015658:HIV Infections / Q000150:complications*; D006509:Hepatitis B / Q000150:complications* / Q000382:microbiology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics / Q000502:physiology; D006716:Homosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D014779:Virus Replication
D015704:CD4 Antigens; D004279:DNA, Viral; D015483:HIV Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase