title: Factors associated with isolated anti-hepatitis B core antibody in HIV-positive patients: impact of compromised immunity.
abstract: In regions that are hyperendemic for chronic hepatitis B virus (HBV) infection, prevalence of and risk factors associated with isolated anti-hepatitis B core antibody (anti-HBc) in HIV-positive patients are less well described. HIV-positive patients who were tested for hepatitis B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs) and anti-HBc at designated hospitals for HIV care in Taiwan were included for analysis. HBV DNA was detected by real-time polymerase chain reaction in patients with and without isolated anti-HBc. Of 2351 HIV-positive patients, 450 (19.1%) were HBsAg positive, 411 (17.5%) were anti-HBc positive alone and 963 (41.0%) for both anti-HBs and anti-HBc. Compared with patients who were positive for both anti-HBs and anti-HBc, patients with isolated anti-HBc were older, less likely to have anti-hepatitis C virus antibody (anti-HCV), had lower CD4 lymphocyte counts and higher plasma HIV RNA loads. Older age (adjusted odds ratio, 1.029; 95% confidence interval, 1.015-1.043) and CD4 <100 cells/microL (adjusted odds ratio, 1.524; 95% confidence interval, 1.025-2.265) were independently associated with isolated anti-HBc by logistic regression, while presence of anti-HCV and injecting drug use were not. HBV DNA was detectable in 8.3% of 277 patients with isolated anti-HBc and 14.3% of 56 patients with both anti-HBs and anti-HBc (P = 0.160). In a country hyperendemic for HBV infection, HIV-positive patients at older age and with CD4 <100 cells/microL were more likely to have isolated anti-HBc, suggesting that compromised immunity plays a role in the presence of this marker.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: H-Y
authors.initials: HY
authors.lastname: Sun
authors.forename: H-C
authors.initials: HC
authors.lastname: Lee
authors.forename: C-E
authors.initials: CE
authors.lastname: Liu
authors.forename: C-L
authors.initials: CL
authors.lastname: Yang
authors.forename: S-C
authors.initials: SC
authors.lastname: Su
authors.forename: W-C
authors.initials: WC
authors.lastname: Ko
authors.forename: C-Y
authors.initials: CY
authors.lastname: Lin
authors.forename: J-J
authors.initials: JJ
authors.lastname: Tsai
authors.forename: W-W
authors.initials: WW
authors.lastname: Wong
authors.forename: M-W
authors.initials: MW
authors.lastname: Ho
authors.forename: S-H
authors.initials: SH
authors.lastname: Cheng
authors.forename: Y-H
authors.initials: YH
authors.lastname: Lin
authors.forename: W-J
authors.initials: WJ
authors.lastname: Miao
authors.forename: C-C
authors.initials: CC
authors.lastname: Hung
mesh_terms: D000293:Adolescent; D000328:Adult; D006678:HIV / Q000276:immunology*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies