Premium
Predictors and kinetics of occult hepatitis B virus infection in HIV‐infected persons
Author(s) -
Nebbia Gaia,
GarciaDiaz Ana,
Ayliffe Ursula,
Smith Colette,
Dervisevic Samir,
Johnson Margaret,
Gilson Richard,
Tedder Richard,
Geretti Anna Maria
Publication year - 2007
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.20954
Subject(s) - hbsag , medicine , lamivudine , hepatitis b virus , virology , occult , antibody , viral load , immunology , virus , pathology , alternative medicine
It has been proposed that occult hepatitis B virus (HBV) infection, defined as detectable HBV‐DNA in serum with undetectable surface antigen (HBsAg − ), is associated with raised transaminases in HIV‐infected persons. The aim of this study was to determine the prevalence of occult HBV infection in two independent cohorts, and investigate its predictors, association with alanine‐aminotransferase (ALT) levels and response to antiretroviral therapy. Sera from HBsAg − persons with core antibody (anti‐HBc + ) were tested by real‐time PCR. Overall, 5.2% of patients were HBsAg + and 39% HBsAg − /anti‐HBc + . The prevalence of occult HBV infection was 48/343 (14.0%; 95% CI 10.7–18.1%), and 27/196 (13.8%) and 21/147 (14.3%) in the two cohorts. Median HBV‐DNA load was 342 (51–147,500) and 60 (25–33,850) copies/ml respectively. HBV‐DNA detection was associated with absence of surface antibody (anti‐HBs), but not with CD4 or ALT levels. Among 11 HBV‐DNA + persons who started antiretroviral therapy containing lamivudine or lamivudine/tenofovir, HBV‐DNA was repeatedly undetectable over median 19 (3–43) months. However, HBV‐DNA detection was intermittent among drug‐naïve persons. Occult HBV infection is common in HBsAg − /anti‐HBc + HIV‐infected patients and predicted by undetectable anti‐HBs. The intermittent nature of HBV‐DNA detection poses a diagnostic challenge, but no association is observed with ALT levels. J. Med. Virol. 79:1464–1471, 2007. © Wiley‐Liss, Inc.