title: Incident Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Men Who Have Sex With Men From Pre-HAART to HAART Periods: A Cohort Study.
abstract: BACKGROUND
  Men who have sex with men (MSM) are at high risk for hepatitis B virus (HBV) infection. Data on the effect of highly active antiretroviral therapy (HAART) on incident HBV infection in HIV-infected and HIV-uninfected MSM are limited.
  
  
  OBJECTIVE
  To determine predictors of incident HBV infection in MSM during pre-HAART and HAART periods.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Cohort of MSM who have, or are at risk for, HIV infection.
  
  
  METHODS
  2375 HBV-uninfected MSM in the Multicenter AIDS Cohort Study.
  
  
  METHODS
  Poisson regression was used to compare incidence rates of HBV infection in the pre-HAART and HAART eras and to identify factors associated with incidence of HBV infection.
  
  
  RESULTS
  In 25,322 person-years of follow-up, 244 incident HBV infections occurred. The unadjusted incidence rate was higher in HIV-infected MSM than in HIV-uninfected MSM (incidence rate ratio [IRR], 1.9 [95% CI, 1.5 to 2.4]) and was significantly lower in the HAART era than in the pre-HAART era among HIV-infected (IRR, 0.2 [CI, 0.1 to 0.4]) and HIV-uninfected (IRR, 0.3 [CI, 0.2 to 0.4]) MSM. Age younger than 40 years (IRR, 2.3 [CI, 1.7 to 3.0]), more than 1 recent sexual partner (IRR, 3.1 [CI, 2.3 to 4.2]), and HIV infection (IRR, 2.4 [CI, 1.8 to 3.1]) were independently associated with higher incidence of HBV infection, whereas HBV vaccination was protective (IRR, 0.3 [CI, 0.2 to 0.4]). Highly active antiretroviral therapy with HIV RNA levels less than 400 copies/mL was associated with protection (IRR, 0.2 [CI, 0.1 to 0.5]), but HAART in those with HIV RNA levels of 400 copies/mL or greater was not.
  
  
  CONCLUSIONS
  The observational nature limits inferences about causality.
  
  
  CONCLUSIONS
  Effective HAART is associated with lower incidence of HBV infection; however, even in the HAART era, incidence of HBV infection remains high among MSM.
  
  
  BACKGROUND
  National Institute of Allergy and Infectious Diseases.
authors.forename: Oluwaseun
authors.initials: O
authors.lastname: Falade-Nwulia
authors.forename: Eric C
authors.initials: EC
authors.lastname: Seaberg
authors.forename: Anna E
authors.initials: AE
authors.lastname: Snider
authors.forename: Charles R
authors.initials: CR
authors.lastname: Rinaldo
authors.forename: John
authors.initials: J
authors.lastname: Phair
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Witt
authors.forename: Chloe L
authors.initials: CL
authors.lastname: Thio
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D015897:Comorbidity; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D006509:Hepatitis B / Q000453:epidemiology*; D006515:Hepatitis B virus; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D012747:Sexual Partners; D019562:Viral Load
chemical_list: D012367:RNA, Viral