title: Occult hepatitis B in HIV-infected patients.
abstract: Prevalence of hepatitis B virus (HBV) markers, including occult HBV, has not been described in diverse cohorts among HIV-infected patients. The objective of this study was to assess prevalence and significance of active and occult HBV infection in an HIV-positive US cohort. A random sample was taken from 2 prospective multicenter treatment intervention cohorts. The sample population (n = 240) was HIV-1 infected and highly active antiretroviral therapy-naive. Prevalence of HBV serologic markers and quantitative HBV DNA were determined. Serum alanine aminotransferase (ALT) levels were measured to evaluate correlates of hepatocyte injury. A total of 64.6% of subjects demonstrated reactivity for any marker of current or past HBV infection or prior vaccination. Chronic HBV infection characterized by hepatitis B surface antigen (HBsAg) reactivity was present in 7.1% while 15.8% exhibited HB anticore IgG only. Approximately 10% of the latter group was HBV DNA positive by a polymerase chain reaction-based assay. Only patients with a serologic pattern of HBsAg or HB anticore alone reactivity had HBV DNA. Occult HBV was observed in approximately 10% of HIV-infected patients with HB anticore IgG antibody in a geographically representative national cohort. Though viral titers and serum ALT levels were low, screening of this subset of HIV-infected patients may have implications in terms of antiretroviral therapy and risk of immune reconstitution-associated flares.
authors.affiliation: University of Cincinnati College of Medicine, OH 45267, USA.
authors.forename: Norah J
authors.initials: NJ
authors.lastname: Shire
authors.forename: Susan D
authors.initials: SD
authors.lastname: Rouster
authors.forename: Natasa
authors.initials: N
authors.lastname: Rajicic
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Sherman
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active; D001219:Aspartate Aminotransferases / Q000097:blood; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase