Risk Of AIDS Higher With Hep B Infection

military soldier

HIV-positive members of the US military starting antiretroviral therapy (ART) with chronic or resolved hepatitis B virus (HBV) infection had a higher risk of AIDS or death than did cohort members without HBV. In contrast, people with chronic HBV gained CD4 cells faster after starting ART than did people without HBV.

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Although HBV coinfection is common with HIV infection because the two viruses share transmission routes, much remains unknown about the potential impact of HBV on clinical outcomes in antiretroviral-treated people. To address that question, the Infectious Disease Clinical Research Program HIV Working Group analyzed ART responses in members of the US Military HIV Natural History Study.

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Researchers divided the cohort into four groups, 1505 HBV-negative people (66%), 518 (23%) with resolved HBV, 139 (6%) with isolated hepatitis B core antigen, and 131 (6%) with chronic HBV infection. The groups did not differ significantly in HIV suppression or treatment failure 6 months or 1 year after starting ART.

During the first 4 to 12 years of ART, people with chronic HBV gained significantly more CD4 cells than people without HBV infection. Despite that advantage, people with chronic HBV infection had a 68% higher risk of AIDS or death than did HBV-negative people (hazard ratio 1.68, 95% confidence interval 1.05 to 2.68), and people with resolved HBV infection had a 61% higher risk of AIDS or death (hazard ratio 1.61, 95% confidence interval 1.15 to 2.25).

The researchers propose that “CD4 cell count reconstitution after [ART initiation] and the risk of an AIDS event or death after [ART initiation] may be associated with hepatitis B status.”

For the study abstract

Reprinted by permission from BlackAIDS.org. 

 

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