title: Prevalence and characteristics of hepatitis B and C virus infections in treatment-naïve HIV-infected patients.
abstract: In HIV-infected treatment-naïve patients, we analyzed risk factors for either chronic hepatitis B (HBV) infection, occult HBV infection (OHBV) or a positive hepatitis C (HCV) serostatus. A total of 918 patients of the RESINA-cohort in Germany were included in this study. Before initiating antiretroviral therapy, clinical parameters were collected and blood samples were analyzed for antibodies against HIV, HBV and HCV, HBs antigen and viral nucleic acids for HIV and HBV. Present or past HBV infection (i.e. HBsAg and/or anti-HBc) was found in 43.4% of patients. HBsAg was detected in 4.5% (41/918) and HBV DNA in 6.1% (34/554), resulting in OHBV infection in 2.9% (16/554) of patients. OHBV infection could not be ruled out by the presence of anti-HBs (50.1%) or the absence of all HBV seromarkers (25%). A HCV-positive serostatus was associated with the IVDU transmission route, non-African ethnicity, elevated liver parameters (ASL or GGT) and low HIV viral load. Replicative HBV infection and HCV-positive serostatus both correlated with HIV resistance mutations (P = 0.001 and P = 0.028). HBV and HCV infection are frequent co-infections in HIV treatment-naive patients. These co-infections influence viral evolution, clinical parameters and serological markers. Consequently, HIV patients should routinely be tested for HBV and HCV infection before initiating HIV treatment. OHBV infection constituted almost half of all HBV infections with detectable HBV DNA. Due to a lack of risk factors indicating OHBV infection, HBV diagnosis should not only include serological markers but also the detection of HBV DNA.
authors.affiliation: Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital, Moorenstr. 5, 40225 Duesseldorf, Germany. Stefan.reuter@med.uni-duesseldorf.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Reuter
authors.forename: Mark
authors.initials: M
authors.lastname: Oette
authors.forename: Frank Clemens
authors.initials: FC
authors.lastname: Wilhelm
authors.forename: Bastian
authors.initials: B
authors.lastname: Beggel
authors.forename: Rolf
authors.initials: R
authors.lastname: Kaiser
authors.forename: Melanie
authors.initials: M
authors.lastname: Balduin
authors.forename: Finja
authors.initials: F
authors.lastname: Schweitzer
authors.forename: Jens
authors.initials: J
authors.lastname: Verheyen
authors.forename: Ortwin
authors.initials: O
authors.lastname: Adams
authors.forename: Thomas
authors.initials: T
authors.lastname: Lengauer
authors.forename: Gerd
authors.initials: G
authors.lastname: Fätkenheuer
authors.forename: Herbert
authors.initials: H
authors.lastname: Pfister
authors.forename: Dieter
authors.initials: D
authors.lastname: Häussinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005858:Germany / Q000453:epidemiology; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000150:complications*; D006509:Hepatitis B / Q000453:epidemiology* / Q000473:pathology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000453:epidemiology* / Q000473:pathology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral