title: High prevalence of hepatitis B virus markers in romanian adolescents with human immunodeficiency virus infection.
abstract: BACKGROUND
  We evaluated the frequency of hepatitis coinfection in Romanian adolescents who were diagnosed with human immunodeficiency virus (HIV) infection prior to 1995.
  
  
  METHODS
  One hundred sixty-one adolescents (13-18 years of age) with symptomatic HIV infection, but without signs of hepatic dysfunction, and 356 age-matched, HIV-uninfected controls underwent laboratory testing for markers of parenterally acquired hepatitis virus infection.
  
  
  RESULTS
  Seventy-eight percent of HIV-infected adolescents had markers of past or present hepatitis B virus (HBV) infection, as compared with 32% of controls (P = .0001). The prevalence of HBV replicative markers was more than 5-fold higher in HIV-infected adolescents as compared with controls: 43.4% vs 7.9% (P = .0001), respectively, for hepatitis B surface antigen (HBsAg); and 11.2% vs 2.2% (P = .0001), respectively, for hepatitis B e antigen (HBeAg). The prevalence of HBsAg chronic carriers and the presence of HBV replicative markers was significantly higher in patients with immunologically defined AIDS (CD4+ cell counts < 200 cells/mcL): 59.6% vs 34.6% (P = .02) for HBsAg and 22.8% vs 5.7%, (P = .002) for HBV DNA. After 1 year of follow-up, the proportion of those who cleared the HBeAg was considerably lower in severely immunosuppressed coinfected patients: 4.7% vs 37.1% (P = .003). Four additional HIV-infected adolescents became HBsAg-positive over the term of follow-up (incidence rate, 24.9/1000 person-years), despite a record of immunization against hepatitis B.
  
  
  CONCLUSIONS
  A substantial percentage of HIV-infected and HIV-uninfected Romanian adolescents have evidence of past or present HBV infection. In HIV-infected adolescents, the degree of immunosuppression is correlated with persistence of HBV replicative markers, even in the absence of clinical or biochemical signs of liver disease.
authors.affiliation: Associate Professor of Virology, Stefan S, Nicolau Institute of Virology, Bucharest, Romania. simonaruta@b.astral.ro.
authors.forename: Simona Maria
authors.initials: SM
authors.lastname: Ruta
authors.forename: Rodica Floarea
authors.initials: RF
authors.lastname: Matusa
authors.forename: Camelia
authors.initials: C
authors.lastname: Sultana
authors.forename: Loredana
authors.initials: L
authors.lastname: Manolescu
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Kozinetz
authors.forename: Mark W
authors.initials: MW
authors.lastname: Kline
authors.forename: Costin
authors.initials: C
authors.lastname: Cernescu