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Seroprevalence and Risk Factors of Hepatitis B, Hepatitis C, and Human Cytomegalovirus Among HIV-Infected and High-Risk Uninfected Adolescents: Findings of the REACH Study

Holland, Christie A. PhD*; Yong, M A MS; Moscicki, Anna Barbara MD; Durako, Stephen J. BA; Levin, Linda MD§; Wilson, Craig M. MDThe Adolescent Medicine HIVAIDS Research Network

Sexually Transmitted Diseases: May 2000 - Volume 27 - Issue 5 - p 296–303
Original Articles

Background and Objectives: In adolescents and young adults, multiple studies have identified sexual activity and behaviors as significant risk factors for acquiring both human cytomegalovirus (HCMV) and hepatitis B virus (HBV). However, there are no reports on the prevalence or risk factors for infection of these viruses and hepatitis C virus (HCV) in an adolescent population with sexually acquired HIV.

Goals: To examine the seroprevalence and risk factors of HBV, HCV, and HCMV infection in a population of HIV-infected male and female adolescents and in an age- and risk behavior-matched HIV-uninfected cohort.

Study Design: A cross-sectional analysis of HBV, HCV, and HCMV infections in a cohort of HIV-infected and HIV-uninfected adolescents.

Results: Adolescent males infected with HIV were more likely to have evidence of HBV and HCMV infection than HIV-uninfected males (23.7% versus 0%, respectively, for HBV, P = 0.008; 79.7% versus 50%, respectively, for HCMV, P = 0.004). HIV-infected females were more likely to have evidence of HCMV infection (78.5% versus 61.4%, P = 0.003) than HIV-uninfected females. No significant difference was found for HBV infection in the two groups of females. The rate of HCV infection (1.6%) was too small to make comparisons between the groups. To determine whether the differences in infection rates for HBV and HCMV could be explained by factors other than HIV status, a variety of possible risk factors were examined using univariate and multivariate analyses. A significant risk factor for HBV and HCMV infections for males was a homosexual or bisexual orientation. For females, a risk factor for HBV infection was having more than 10 lifetime sexual partners; for HCMV infection, HIV infection was the only risk factor. In addition, in the HIV-infected cohort, 15% of females and 36% of males who were seropositive for HBV had evidence of active HBV infection.

Conclusions: These results emphasize the need for continued development of primary and secondary prevention programs and clinical screening and treatment for HBV and HCMV in adolescents.

*From the Children's National Medical Center, Washington, DC; †Westat, Rockville, Maryland; the ‡Department of Pediatrics, University of California at San Francisco, San Francisco, California; §Mount Sinai Medical Center, New York, New York; and the ∥Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama

The Adolescent Medicine HIV/AIDS Research Network is funded by the National Institute of Child Health and Human Development, with supplemental funding from National Institutes on Drug Abuse, Allergy and Infectious Diseases, and Mental Health.

The investigators are grateful to the members of the Community Advisory Board for their insight and counsel, and are particularly indebted to the youth who are participating in the study.

Staff from sponsoring agencies include A. Rogers, (NICHD), K. Davenny, V. Smeriglio (NIDA), E. Matzen, (NIAID), B. Vitiello (NIMH), G. Weissman (HRSA). Investigators are listed in order of the numbers of subjects enrolled (see Appendix).

Reprint requests: Christie A. Holland, PhD, Center I/5R, Center for Virology, Immunology, and Infectious Disease Research, Children's National Medical Center, Michigan Avenue Northwest, Washington, DC 20010.

Received for publication August 31, 1999, revised November 18, 1999, and accepted November 23, 1999.

© Copyright 2000 American Sexually Transmitted Diseases Association