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Occult hepatitis B virus infection in a Cohort of HIV-positive patients: Correlation with hepatitis C virus coinfection, virological and immunological features

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Abstract

Background:

An evaluation of the prevalence of occult hepatitis B virus (HBV) infection in HIV-positive individuals is important as HBV infection may have an impact on the outcome of the liver disease in these patients.

Materials and Methods:

Of the 1,593 HIV-positive subjects enrolled in the Italian Cohort Naïve Antiretroviral (ICONA) program, 175 (10.9%) were selected for inclusion in the study on the basis of hepatitis B surface antigen (HBsAg) negativity and antibody to hepatitis B core antigen (anti- HBc) positivity; 101/175 (58%) were also anti-hepatitis C virus (HCV) positive. HBV-DNA was detected in plasma using a highly sensitive PCR assay (detection limit: 2.6 copies/ml). Two different genomic regions were assayed. Quantification was performed by real-time PCR. The HBV genotype was determined in 20 cases with occult HBV infection. Data on the antiretroviral therapy (ART) regimen was obtained in 169 individuals: 53 (31.4%) patients were ART-naive, 46 (27.2%) were under ART without lamivudine or tenofovir, and the remaining 70 (41.4%) were under ART including lamivudine or tenofovir.

Results:

27/175 (15%) patients had detectable HBV-DNA in their plasma: 21/101 (21%) were anti-HCV positive and 6/74 (8%) were anti-HCV negative. Genotype D was invariably found in the 20 cases analyzed. Occult HBV infection was significantly higher in HCV-coinfected subjects: adjusted OR 5.02, 95% CI 1.31–19.26, p = 0.02. The value was not associated with immune status, HIV load, or ART regimen.

Conclusions:

In relation to the high prevalence of occult HBV infection, particularly in HIV/HCV-coinfected individuals, it is necessary to clarify the clinical impact of this cryptic infection by monitoring HBV-DNA in plasma using the correct approach. Similarly to HBsAg-positive individuals of the Mediterranean area, HBV genotype D is invariably detected in this cohort of HIV-infected patients with occult HBV infection.

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Authors and Affiliations

  1. Dept. of Infectious Diseases, S. Raffaele Scientific Institute, Via Stamira d’Ancona, 20, 20127, Milan, Italy

    G. Morsica, S. Bagaglio & A. Lazzarin

  2. Institute of Infectious Diseases and Public Health, University of Ancona, Ancona, Italy

    F. Ancarani & M. Maracci

  3. Institute of Infectious and Tropical Diseases, S. Paolo Hospital, University of Milan, Milan, Italy

    P. Cicconi & A. D’Arminio Monforte

  4. Royal Free and University College Medical School, London, UK

    A. Cozzi Lepri

  5. National Institute of Infectious Diseases “L. Spallanzani”, Rome, Italy

    G. Antonucci

  6. Institute of Infectious and Tropical Diseases, IRCCS S. Matteo, University of Pavia, Pavia, Italy

    R. Bruno

  7. Institute of Infectious Diseases, University of Bari, Bari, Italy

    T. Santantonio

  8. Centro di riferimento AIDS, Latina, Italy

    L. Tacconi

  9. Institute of Infectious Diseases, University of Perugia, Perugia, Italy

    F. Baldelli

  10. Department of Infectious Diseases, E.O. Ospedale Galliera, Genoa, Italy

    R. Piscopo

  11. Department of Infectious Diseases, S. Anna Hospital, Como, Italy

    D. Santoro

  12. Ateneo Vita e Salute, S. Raffaele, Scientific Institute Milano, Milan, Italy

    A. Lazzarin

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  1. G. Morsica
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  2. F. Ancarani
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  3. S. Bagaglio
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  4. M. Maracci
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  5. P. Cicconi
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  7. G. Antonucci
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  8. R. Bruno
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  9. T. Santantonio
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  10. L. Tacconi
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  11. F. Baldelli
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  13. D. Santoro
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  14. A. Lazzarin
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  15. A. D’Arminio Monforte
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Consortia

HepaICONA and the ICONA Study Groups

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Correspondence to G. Morsica.

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Morsica, G., Ancarani, F., Bagaglio, S. et al. Occult hepatitis B virus infection in a Cohort of HIV-positive patients: Correlation with hepatitis C virus coinfection, virological and immunological features. Infection 37, 445–449 (2009). https://doi.org/10.1007/s15010-008-8194-9

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  • DOI: https://doi.org/10.1007/s15010-008-8194-9

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