title: Hepatitis B virus coinfection negatively impacts HIV outcomes in HIV seroconverters.
abstract: BACKGROUND
  Understanding the impact of hepatitis B virus (HBV) in human immunodeficiency virus (HIV) coinfection has been limited by heterogeneity of HIV disease. We evaluated HBV coinfection and HIV-related disease progression in a cohort of HIV seroconverters.
  
  
  METHODS
  Participants with HIV diagnosis seroconversion window of ≤ 3 years and serologically confirmed HBV infection (HB) status were classified at baseline into 4 HB groups. The risk of clinical AIDS/death in HIV seroconverters was calculated by HB status.
  
  
  RESULTS
  Of 2352 HIV seroconverters, 474 (20%) had resolved HB, 82 (3%) had isolated total antibody to hepatitis B core antigen (HBcAb), and 64 (3%) had chronic HB. Unadjusted rates (95% confidence intervals [CIs]) of clinical AIDS/death for the HB-negative, resolved HB, isolated HBcAb, and chronic HB groups were 2.43 (2.15-2.71); 3.27 (2.71-3.84); 3.75 (2.25-5.25); and 5.41 (3.41-7.42), respectively. The multivariable risk of clinical AIDS/death was significantly higher in the chronic HB group compared to the HB-negative group (hazard ratio [HR], 1.80; 95% CI, 1.20-2.69); while the HRs were increased but nonsignificant for those with resolved HB (HR, 1.17; 95% CI, .94-1.46) and isolated HBcAb (HR, 1.14; 95% CI, .75-1.75).
  
  
  CONCLUSIONS
  HBV coinfection has a significant impact on HIV outcomes. The hazard for an AIDS or death event is almost double for those with chronic HB compared, with HIV-monoinfected persons.
authors.affiliation: Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Chun
authors.forename: Mollie P
authors.initials: MP
authors.lastname: Roediger
authors.forename: Katherine Huppler
authors.initials: KH
authors.lastname: Hullsiek
authors.forename: Chloe L
authors.initials: CL
authors.lastname: Thio
authors.forename: Brian K
authors.initials: BK
authors.lastname: Agan
authors.forename: William P
authors.initials: WP
authors.lastname: Bradley
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Peel
authors.forename: Linda L
authors.initials: LL
authors.lastname: Jagodzinski
authors.forename: Amy C
authors.initials: AC
authors.lastname: Weintrob
authors.forename: Anuradha
authors.initials: A
authors.lastname: Ganesan
authors.forename: Glenn
authors.initials: G
authors.lastname: Wortmann
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
authors.forename: Jason D
authors.initials: JD
authors.lastname: Maguire
authors.forename: Michael L
authors.initials: ML
authors.lastname: Landrum
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000453:epidemiology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000821:virology*; D018450:Disease Progression; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000821:virology*; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications* / Q000821:virology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D055815:Young Adult
chemical_list: D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens