HIV outcomes in Hepatitis B virus coinfected individuals on HAART.
BACKGROUND
Understanding the impact of hepatitis B virus (HBV) coinfection on HIV outcomes in the highly active antiretroviral therapy (HAART) era continues to be a critical priority given the high prevalence of coinfection and the potential for impaired immunologic, virologic, and clinical recovery.


METHODS
Participants from the US Military HIV Natural History Study with an HIV diagnosis on HAART and serologically confirmed HBV infection status at HAART initiation (HI) were classified into 4 HBV infection (HB) groups. HIV virologic, immunologic, and clinical outcomes were evaluated by HB status.


RESULTS
Of 2536 HIV-positive HAART recipients, with HBV testing results available to determine HB status in the HI window, HB status at HI was classified as HB negative (n = 1505; 66%), resolved HB (n = 518; 23%), isolated hepatitis B core antigen (n = 139; 6%), or chronic HB (n = 131; 6%). HIV virologic suppression and failure at 6 months or 1 year were not significantly different by HB status. A significantly faster rate of increase in CD4 cell count during the period between 4 and 12 years was observed for chronic HB relative to HB negative. Chronic and resolved HB were associated with an increased risk of AIDS/death compared with HB-negative individuals (chronic HB-hazard ratio = 1.68, 95% confidence interval: 1.05 to 2.68; resolved HB-hazard ratio = 1.61, 95% confidence interval: 1.15 to 2.25).


CONCLUSIONS
HB status did not have a significant impact on HIV virologic outcomes, however, CD4 cell count reconstitution after HI and the risk of an AIDS event or death after HI may be associated with HB status.
*Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD; †Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD; ‡US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD; §Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, MD; ‖Infectious Disease Clinic, Naval Medical Center, San Diego, CA; ¶Division of Infectious Diseases, Naval Medical Center, Portsmouth, VA; and #Bellin Health Green Bay and Clinica Hispana, Green Bay, WI.
Helen M
HM
Chun
Octavio
O
Mesner
Chloe L
CL
Thio
Ionut
I
Bebu
Grace
G
Macalino
Brian K
BK
Agan
William P
WP
Bradley
Jennifer
J
Malia
Sheila A
SA
Peel
Linda L
LL
Jagodzinski
Amy C
AC
Weintrob
Anuradha
A
Ganesan
Mary
M
Bavaro
Jason D
JD
Maguire
Michael L
ML
Landrum
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000188:drug therapy* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy*; D006512:Hepatitis B Core Antigens / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D055815:Young Adult
D006512:Hepatitis B Core Antigens