Spontaneous loss of HBeAg and the prevalence of HTLV-III/LAV infection in a cohort of homosexual hepatitis B virus carriers and the implications for antiviral therapy.
The future design of controlled trials of antiviral therapy which might include homosexual hepatitis B virus (HBV) carriers requires base-line data on the spontaneous rate of loss of HBeAg and the prevalence of human T-lymphotropic virus III (HTLV-III/LAV) infection. Fifty-one untreated HBsAg and HBeAg-positive homosexual HBV carriers were followed for a median HBeAg-positive time of 23.5 months (range 6-85.5). Ten lost HBeAg, giving an annual rate of spontaneous loss of HBeAg of 10%. This rate is considerably higher than the apparent rate in a previous report and has considerable implications for the interpretation of previous, and the design of future, controlled trials in this population. A rapid rise in the prevalence of anti-HTLV-III/LAV amongst HBV carriers was demonstrated from 1981 such that by 1984 over 60% of HBV carriers were anti-HTLV-III-positive. HBV-DNA polymerase levels were not significantly different in asymptomatic anti-HTLV-III/LAV-positive compared to anti-HTLV-III/LAV-negative HBV carriers. Nevertheless, since chronic HTLV-III/LAV infection in its later stages may potentiate HBV replication, it is a factor that will need to be considered together with many others in any trial stratification procedure.
Weller
I V
IV
Brown
A
A
Morgan
B
B
Hawkins
A
A
Briggs
M
M
Waite
J
J
Cameron
C H
CH
Tedder
R
R
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002353:Carrier State / Q000276:immunology*; D002986:Clinical Trials as Topic; D006509:Hepatitis B / Q000150:complications*; D006513:Hepatitis B e Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000502:physiology; D006716:Homosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D014779:Virus Replication
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens