Hepatitis B virus reactivation or reinfection associated with HIV-1 infection.
Following acute hepatitis B virus (HBV) infection, most individuals develop antibodies to HBV surface (anti-HBs) and core antigen (anti-HBc). Prevalence studies have shown that 10-18% develop anti-HBc in the absence of detectable anti-HBs. We report four such cases, all with persistence of serum anti-HBc, who had evidence of a second period of active HBV replication as demonstrated by the reappearance of serum hepatitis B surface antigen (HBsAg). In one patient, an HBsAg subtype difference indicated that the second period of HBsAg-positivity was due to a reinfection. In the other cases, reactivation may also explain the findings. All cases were anti-HIV-1 seropositive at the time of reappearance of HBsAg. There is experimental evidence that anti-HBc has a protective effect against HBV infection; however, this may require intact cell-mediated immunity to be effective. HIV-1 infection may render such patients susceptible to reinfection. Alternatively, some patients with anti-HBc, but without detectable anti-HBs may have latent HBV infection. Immunosuppression associated with HIV-1 infection may allow reactivation.
Waite
J
J
Department of Medical Microbiology, University College and Middlesex School of Medicine, London, UK.
Gilson
R J
RJ
Weller
I V
IV
Lacey
C J
CJ
Hambling
M H
MH
Hawkins
A
A
Briggs
M
M
Tedder
R S
RS
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D015497:HIV-1; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D006510:Hepatitis B Antibodies / Q000302:isolation & purification; D006514:Hepatitis B Surface Antigens / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000502:physiology; D006801:Humans; D008297:Male; D014779:Virus Replication
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens