title: HIV and Hepatitis B coinfection among perinatally HIV-infected Thai adolescents.
abstract: OBJECTIVE
  This study aimed to determine the prevalence of hepatitis B virus (HBV) coinfection and HBV seropositivity in perinatally HIV-infected adolescents. A secondary objective was to describe the clinical characteristics of adolescents with chronic HBV/HIV coinfection.
  
  
  METHODS
  Multicenter cross-sectional study of perinatally HIV-infected adolescents aged 12-25 years. HBV surface antigen, surface antibody (anti-HBs) and core antibody (anti-HBc) were measured. Coinfection was defined as having persistently positive HBV surface antigen. Seroprotective antibody from immunization was defined as having anti-HBs ≥10 mIU/mL with negative anti-HBc. HBV DNA quantitation and rtM204V/I mutation analysis (lamivudine resistance-associated mutation) were performed in adolescents with chronic HBV infection.
  
  
  RESULTS
  From November 2010 to March 2011, 521 patients were enrolled. Mean (SD) of CD4 lymphocyte count was 685 (324) cells/μL. The prevalence of HBV/HIV coinfection was 3.3% (95% confidence interval: 1.9-5.2%). Protective antibody against HBV was found in 18% of population, and this was significantly higher among adolescents who received than those who did not receive HBV revaccination after receiving antiretroviral therapy (93% versus 6%, P < 0.01). Among adolescents with chronic HBV infection, 88% have received lamivudine; however, 69% have HBV DNA >10 copies/mL and 75% had the rtM204V/I mutation.
  
  
  CONCLUSIONS
  The prevalence of HBV coinfection in HIV-infected Thai adolescents was 3.3%. Most HIV-infected adolescents had no HBV protective antibody; therefore, revaccination with HBV vaccine is encouraged. The high prevalence of HBV-lamivudine resistance underscores the importance of HBV screening prior to antiretroviral therapy initiation to guide the selection of optimal regimen for coinfected children.
authors.affiliation: Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Linda
authors.initials: L
authors.lastname: Aurpibul
authors.forename: Pagakrong
authors.initials: P
authors.lastname: Lumbiganon
authors.forename: Pope
authors.initials: P
authors.lastname: Kolasaraksa
authors.forename: Rawiwan
authors.initials: R
authors.lastname: Hansudewechakul
authors.forename: Pattaratida
authors.initials: P
authors.lastname: Sa-Nguanmoo
authors.forename: Pawinee
authors.initials: P
authors.lastname: Taeprasert
authors.forename: Torsak
authors.initials: T
authors.lastname: Bunupuradah
authors.forename: Yong
authors.initials: Y
authors.lastname: Poovorawan
authors.forename: Virat
authors.initials: V
authors.lastname: Sirisanthana
authors.forename: Thanyawee
authors.initials: T
authors.lastname: Puthanakit
mesh_terms: D000293:Adolescent; D000328:Adult; D060085:Coinfection / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000635:transmission / Q000821:virology*; D006509:Hepatitis B / Q000821:virology*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D015995:Prevalence