title: HIV through the looking glass: insights derived from Hepatitis B.
abstract: BACKGROUND
  Although higher levels of hepatitis B virus (HBV) replication in HIV-HBV co-infection may relate to liver disease progression, this has not been completely elucidated. We used expression of hepatitis B core antigen (HBcAg) in liver biopsies from HIV-HBV co-infected and HBV mono-infected patients as a marker for HBV replication, and related these findings to clinical and histological parameters.
  
  
  METHODS
  Data from 244 HBV patients were compared with 34 HIV-HBV patients. Liver biopsies were scored for inflammation, fibrosis, HBcAg, and hepatitis B surface antigen. Univariate and multivariate analyses were performed.
  
  
  RESULTS
  HBcAg, but not hepatitis B surface antigen, staining was stronger in HIV co-infected than in HBV mono-infected. Co-infected and HBV mono-infected had similar alanine aminotransferase, inflammatory and fibrosis scores, and hepatitis B e antigen status. HBcAg staining correlated with HIV after correcting for HBV DNA and hepatitis B e antigen. CD4 counts and HIV RNA level did not correlate with intensity of HBcAg staining. HBV DNA levels were higher in HIV co-infected and correlated with HBcAg staining.
  
  
  CONCLUSIONS
  By looking at HBcAg as a reflection of HBV replication in HIV-HBV co-infected with controlled HIV, our findings suggest that these patients may have subtle immune function defects, which could lead to adverse liver disease outcomes.
authors.affiliation: *Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD; †Pontificia Universidad Católica de Chile, National Institutes of Health, Bethesda, MD; ‡National Cancer Institute, National Institutes of Health, Bethesda, MD; §Clinical Center, National Institutes of Health, Bethesda, MD; and ‖National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Rivera
authors.forename: Alejandro
authors.initials: A
authors.lastname: Soza
authors.forename: Alison
authors.initials: A
authors.lastname: Jazwinski
authors.forename: Lijun
authors.initials: L
authors.lastname: Mi
authors.forename: David E
authors.initials: DE
authors.lastname: Kleiner
authors.forename: Xiongce
authors.initials: X
authors.lastname: Zhao
authors.forename: Charma
authors.initials: C
authors.lastname: Zuber
authors.forename: Douglas
authors.initials: D
authors.lastname: Brust
authors.forename: Emory
authors.initials: E
authors.lastname: Hsu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Simpson
authors.forename: Jay H
authors.initials: JH
authors.lastname: Hoofnagle
authors.forename: Theo
authors.initials: T
authors.lastname: Heller
mesh_terms: D000328:Adult; D001706:Biopsy; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000473:pathology*; D006512:Hepatitis B Core Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000502:physiology*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006651:Histocytochemistry; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D014779:Virus Replication
chemical_list: D006512:Hepatitis B Core Antigens