Factors associated with isolated anti-hepatitis B core antibody in HIV-positive patients: impact of compromised immunity.
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.
Sun
H-Y
HY
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Lee
H-C
HC
Liu
C-E
CE
Yang
C-L
CL
Su
S-C
SC
Ko
W-C
WC
Lin
C-Y
CY
Tsai
J-J
JJ
Wong
W-W
WW
Ho
M-W
MW
Cheng
S-H
SH
Lin
Y-H
YH
Miao
W-J
WJ
Hung
C-C
CC
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
D006510:Hepatitis B Antibodies