Predictors of loss of hepatitis B surface antigen in patients co-infected with HIV and HBV

Mar 30, 2010

Co-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) poses a treatment challenge. In Western Europe and the United States, chronic HBV infection has been found in 6% of HIV-positive patients and this co-infection is well known to be associated with increased liver-related morbidity and mortality. However, factors associated with HBV surface antigen (HbsAg) loss in HIV and HBV co-infected patients remain unclear.

A research article to be published on March 7, 2010 in the addresses this question. The research team from St.Luke's-Roosevelt Hospital Center, New York City, USA performed a retrospective chart review of 5681 patients followed up at St.Luke's-Roosevelt Hospital HIV clinic (the Center for Comprehensive Care) in New York City from Jan 1999 to May 2007. HIV and HBV co-infection was defined as positive and HBsAg serology. The authors compared patients with HBsAg loss to the rest of the cohort at baseline and at time of loss of HBsAg. Clinical and laboratory parameters including baseline and follow-up HIV viral loads, CD4 cell counts, alanine aminotransferase (ALT) levels, HCV co-infection, demographics, and duration of anti-HBV therapy were analyzed to determine factors associated with loss of HBsAg.

Of the 5681 HIV infected patients in the cohort, 355 patients were HIV and HBV co-infected and were evaluated. Of these, 226 patients with more than 12 mo follow-up were included in the further analysis to better estimate factors associated with loss of HBsAg in the long-term follow-up. The patients were observed for a mean duration of 45.6 mo (range, 20.8󈞩.1 mo). During the follow-up period, 21 patients lost HBsAg.

In the univariate analysis, baseline CD4 cell count was associated with loss of HBsAg (P = 0.052). Other factors, including baseline ALT, presence of hepatitis C virus co-infection, baseline HIV viral load, HIV viral load at end of follow-up, CD4 cell count at end of follow-up, CD4 cell count gain, and treatment with dually active antiretrovirals were not related to loss of HBsAg .

Cox regression analysis revealed that baseline CD4 cell count > 500 cells/mm3 was associated with loss of HBsAg.

The study showed an interesting association of HBsAg loss in HIV-HBV co-infected patients with higher CD4 cell count, suggesting that T-cell cytolytic activity against HBV may still be effective in clearing HBV infection.

Explore further: Can social media help stop the spread of HIV?

More information: Psevdos G Jr, Kim JH, Suh JS, Sharp VL. Predictors of loss of hepatitis B surface antigen in HIV-infected patients. World J Gastroenterol 2010; 16(9): 1093-1096 www.wjgnet.com/1007-9327/16/1093.asp

add to favorites email to friend print save as pdf

Related Stories

New studies examine elimination of hepatitis B and C

Apr 01, 2009

Two new studies in the April issue of Hepatology explore the ways that hepatitis B virus (HBV) and hepatitis C virus (HCV) can be cleared from patients' bodies. Hepatology is a journal published by John Wiley & Sons on beh ...

HIV measurement is questioned

Sep 27, 2006

Preliminary U.S. research indicates the HIV RNA level in untreated HIV-infected patients has little value in predicting the rate of CD4 cell count decrease.

Why are T cells tolerant to hepatitis B virus?

Oct 14, 2008

The level of PD-1 expression has been proved by recent studies to be positively correlated with the extent of HBV-specific T cell impairments. However, the degree of T cell exhaustion which affects the disease statuses of ...

Recommended for you

Model explains why HIV prevention dosing differs by sex

5 hours ago

A mathematical model developed by NIH grantees predicts that women must take the antiretroviral medication Truvada daily to prevent HIV infection via vaginal sex, whereas just two doses per week can protect men from HIV infection ...

Tourism as a driver of illicit drug use, HIV risk in the DR

Oct 29, 2014

The Caribbean has the second highest global human immunodeficiency virus (HIV) prevalence in the world outside of Sub-Saharan Africa, with HIV/AIDS as leading cause of death among people aged 20–59 years within the region. ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.