title: Association between syphilis, antibodies to herpes simplex virus type 2, and recreational drug use and hepatitis B virus infection in the Women's Interagency HIV Study.
abstract: BACKGROUND
  Liver disease is a leading cause of death in human immunodeficiency virus (HIV)-infected women; however, risk factors for hepatitis b virus (hbv) infection in this population have not been well studied.
  
  
  METHODS
  We describe the seroprevalence and predictors of HBV infection in a cross-sectional analysis of 2132 women with and at risk for HIV infection enrolled in the Women's Interagency HIV Study during the periods 1994-95 and 2001-02. Any test result positive for antibody to hepatitis B core antigen defined infection; those women with serological evidence of vaccine immunity were excluded from analysis. Women were stratified into those with a history of injection drug use (IDU), those with a history of noninjection drug use (non-IDU), and those with no history of illicit drug use.
  
  
  RESULTS
  Of 1606 HIV-infected and 526 HIV-uninfected women, 7% and 12%, respectively, appeared to be vaccine immune. After exclusion of these women, 43% of 1500 HIV-infected and 22% of 461 HIV-uninfected women had HBV infection. HBV infection prevalence differed among the IDU, non-IDU, and no illicit drug use groups (76%, 30%, and 17%, respectively; P<.0001). HBV infection was strongly associated with herpes simplex virus 2 (HSV-2) seropositivity in the IDU group (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.6-5.4) and with a history of syphilis in the non-IDU group (OR, 2.7; 95% CI, 1.4-5.0).
  
  
  CONCLUSIONS
  We found a high prevalence of HBV infection in our cohort of women with and at risk for HIV infection. HSV-2 seropositivity and a history of syphilis appeared to be important correlates of HBV infection. Sexual transmission of HBV, particularly in those with a history of genital ulcer disease, should be a major focus of education in all high-risk groups.
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA. ptien@medicine.ucsf.edu
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
authors.forename: Andrea
authors.initials: A
authors.lastname: Kovacs
authors.forename: Peter
authors.initials: P
authors.lastname: Bacchetti
authors.forename: Audrey L
authors.initials: AL
authors.lastname: French
authors.forename: Michael
authors.initials: M
authors.lastname: Augenbraun
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.forename: Nancy
authors.initials: N
authors.lastname: Hessol
authors.forename: Jessica
authors.initials: J
authors.lastname: Justman
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006509:Hepatitis B / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D015999:Multivariate Analysis; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology*
chemical_list: D000914:Antibodies, Viral