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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31825eb0ad
HIV Reports

HIV and Hepatitis B Coinfection Among Perinatally HIV-infected Thai Adolescents

Aurpibul, Linda MD*; Lumbiganon, Pagakrong MD; Kosalaraksa, Pope MD; Hansudewechakul, Rawiwan MD; Sa-nguanmoo, Pattaratida PhD§; Taeprasert, Pawinee MD; Bunupuradah, Torsak MD; Poovorawan, Yong MD§; Sirisanthana, Virat MD*; Puthanakit, Thanyawee MD¶║

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Objectives: This study aimed to determine the prevalence of hepatitis B virus (HBV) coinfection and HBV seropositivity in perinatally HIV-infected adolescents. A secondary objective was to describe the clinical characteristics of adolescents with chronic HBV/HIV coinfection.

Materials and Methods: Multicenter cross-sectional study of perinatally HIV-infected adolescents aged 12–25 years. HBV surface antigen, surface antibody (anti-HBs) and core antibody (anti-HBc) were measured. Coinfection was defined as having persistently positive HBV surface antigen. Seroprotective antibody from immunization was defined as having anti-HBs ≥10 mIU/mL with negative anti-HBc. HBV DNA quantitation and rtM204V/I mutation analysis (lamivudine resistance–associated mutation) were performed in adolescents with chronic HBV infection.

Results: From November 2010 to March 2011, 521 patients were enrolled. Mean (SD) of CD4 lymphocyte count was 685 (324) cells/μL. The prevalence of HBV/HIV coinfection was 3.3% (95% confidence interval: 1.9–5.2%). Protective antibody against HBV was found in 18% of population, and this was significantly higher among adolescents who received than those who did not receive HBV revaccination after receiving antiretroviral therapy (93% versus 6%, P < 0.01). Among adolescents with chronic HBV infection, 88% have received lamivudine; however, 69% have HBV DNA >105 copies/mL and 75% had the rtM204V/I mutation.

Conclusions: The prevalence of HBV coinfection in HIV-infected Thai adolescents was 3.3%. Most HIV-infected adolescents had no HBV protective antibody; therefore, revaccination with HBV vaccine is encouraged. The high prevalence of HBV-lamivudine resistance underscores the importance of HBV screening prior to antiretroviral therapy initiation to guide the selection of optimal regimen for coinfected children.

© 2012 Lippincott Williams & Wilkins, Inc.


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