Serologic examination of hepatitis B infection and immunization in HIV-positive youth and associated risks. The Pediatric AIDS Clinical Trials Group Protocol 220 Team.
This seroprevalence report examines serologic evidence of hepatitis B immunization or infection and associated demographic/behavioral factors in adolescent (aged 12-20) subjects enrolled in a nontherapeutic clinical trial at 43 Pediatric AIDS Clinical Trials Group (PACTG) clinical centers. Subjects (n = 94) infected with the human immunodeficiency virus (HIV) through sexual activity were categorized as hepatitis B virus (HBV)-immunized, HBV-infected, or nonimmune by hepatitis B serology performed on specimens collected within the subject's first 48 weeks on study (1993-1995). Sixteen percent of the 94 serologically classified subjects were immunized; 19% HBV-infected; 65% nonimmune. Of the three risk factor scores examined (sociodemographic, sexual, and substance abuse), substance use alone demonstrated a significant difference among groups (despite virtually no reported injecting drug behavior), with the sexual risk score exhibiting marginally significant differences. Logistic regression analysis (restricted to nonimmunized subjects) showed that male-male sexual activity raised the odds of HBV infection by a factor of 5.14 (95% confidence interval [CI]: 1.45-18. 23) relative to heterosexual activity; and that for every one point increase on the substance abuse risk scale the odds of infection increased 5% (95% CI: 0.99-1.10). The HBV infection rate in PACTG 220 HIV-positive females is twice United States population-based rates; the rate in PACTG 220 HIV-positive males is nearly seven times higher. Past immunization efforts in this population appear to have been based on sexual activity volume without regard to injecting-drug use in sex partners.
Rogers
A S
AS
Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, NIH, Bethesda, Maryland 20892-7510, USA. ar44n@nih.gov
Lindsey
J C
JC
Futterman
D C
DC
Zimmer
B
B
Abdalian
S E
SE
D'Angelo
L J
LJ
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006509:Hepatitis B / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines; D006801:Humans; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D011237:Predictive Value of Tests; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines