title: Long-term serologic follow-up of isolated hepatitis B core antibody in HIV-infected and HIV-uninfected women.
abstract: BACKGROUND
  Isolated antibody to hepatitis B core antigen (anti-HBc) is a common serologic finding in persons infected with human immunodeficiency virus (HIV), but the outcome and clinical significance are uncertain.
  
  
  METHODS
  We performed repeated hepatitis B virus (HBV) serologic tests on women who participated in the Women's Interagency HIV Study and who had isolated anti-HBc at study entry.
  
  
  RESULTS
  Repeated serologic tests were performed for 322 women (282 HIV-infected and 40 HIV-uninfected) at a median of 7.5 years after study entry. Seventy-one percent of women retained isolated anti-HBc serologic status, 20% acquired antibody to hepatitis B surface antigen (anti-HBs), and 2% acquired hepatitis B surface antigen (HBsAg). In unadjusted analysis, increasing age, injection drug use, and hepatitis C viremia were negatively associated with acquisition of anti-HBs. For HIV-infected women, predictors of acquisition of anti-HBs were an increase in CD4 cell count and the use of highly active antiretroviral therapy (HAART). Receipt of drugs with activity against HBV and self-reported HBV vaccination did not predict anti-HBs acquisition. In the multivariable regression model, HAART use remained a significant predictor of anti-HBs acquisition, whereas women with hepatitis C viremia were more likely to retain isolated anti-HBc serologic status.
  
  
  CONCLUSIONS
  Isolated anti-HBc status remained stable over time for the majority of women, especially women with chronic hepatitis C virus infection. Development of anti-HBs was predicted by HAART use and an increase in CD4 cell count. We conclude that a proportion of HIV-infected women with isolated anti-HBc have prior natural HBV infection with anti-HBs that is at an undetectable level because of immune dysfunction. Isolated anti-HBc in the presence of chronic hepatitis C virus infection may be attributable to a different phenomenon, such as dysfunctional antibody production.
authors.affiliation: CORE Center/ Stroger Hospital of Cook County, Northwestern University, Chicago, Illinois 60612, USA. Audrey_French@rush.edu
authors.forename: Audrey L
authors.initials: AL
authors.lastname: French
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Lin
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Lorie
authors.initials: L
authors.lastname: Benning
authors.forename: Marshall J
authors.initials: MJ
authors.lastname: Glesby
authors.forename: Mary A
authors.initials: MA
authors.lastname: Young
authors.forename: Eva A
authors.initials: EA
authors.lastname: Operskalski
authors.forename: Michael
authors.initials: M
authors.lastname: Augenbraun
authors.forename: Marion
authors.initials: M
authors.lastname: Peters
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006509:Hepatitis B / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000097:blood / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens