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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000142
Epidemiology and Prevention

HIV Outcomes in Hepatitis B Virus Coinfected Individuals on HAART

Chun, Helen M. MD*; Mesner, Octavio MS*; Thio, Chloe L. MD; Bebu, Ionut PhD*; Macalino, Grace PhD*; Agan, Brian K. MD*; Bradley, William P. MS*; Malia, Jennifer PhD*,‡; Peel, Sheila A. PhD*,‡; Jagodzinski, Linda L. PhD*,‡; Weintrob, Amy C. MD*,§; Ganesan, Anuradha MD*,§; Bavaro, Mary MD*,‖; Maguire, Jason D. MD*,¶; Landrum, Michael L. MD#; the Infectious Disease Clinical Research Program HIV Working Group

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Abstract

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.

© 2014 by Lippincott Williams & Wilkins

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