Predictors of loss of hepatitis B surface antigen in patients co-infected with HIV and HBV

March 30, 2010

Co-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) poses a treatment challenge. In Western Europe and the United States, chronic HBV infection has been found in 6%󈝺% of HIV-positive patients and this co-infection is well known to be associated with increased liver-related morbidity and mortality. However, factors associated with HBV surface antigen (HbsAg) loss in HIV and HBV co-infected patients remain unclear.

A research article to be published on March 7, 2010 in the World Journal of Gastroenterology addresses this question. The research team from St.Luke's-Roosevelt Hospital Center, New York City, USA performed a retrospective chart review of 5681 patients followed up at St.Luke's-Roosevelt Hospital HIV clinic (the Center for Comprehensive Care) in New York City from Jan 1999 to May 2007. HIV and HBV co-infection was defined as positive HIV infection and HBsAg serology. The authors compared patients with HBsAg loss to the rest of the cohort at baseline and at time of loss of HBsAg. Clinical and laboratory parameters including baseline and follow-up HIV viral loads, CD4 cell counts, alanine aminotransferase (ALT) levels, HCV co-infection, demographics, and duration of anti-HBV therapy were analyzed to determine factors associated with loss of HBsAg.

Of the 5681 HIV infected patients in the cohort, 355 patients were HIV and HBV co-infected and were evaluated. Of these, 226 patients with more than 12 mo follow-up were included in the further analysis to better estimate factors associated with loss of HBsAg in the long-term follow-up. The patients were observed for a mean duration of 45.6 mo (range, 20.8󈞩.1 mo). During the follow-up period, 21 patients lost HBsAg.

In the univariate analysis, baseline CD4 cell count was associated with loss of HBsAg (P = 0.052). Other factors, including baseline ALT, presence of hepatitis C virus co-infection, baseline HIV viral load, HIV viral load at end of follow-up, CD4 cell count at end of follow-up, CD4 cell count gain, and treatment with dually active antiretrovirals were not related to loss of HBsAg .

Cox regression analysis revealed that baseline CD4 cell count > 500 cells/mm3 was associated with loss of HBsAg.

The study showed an interesting association of HBsAg loss in HIV-HBV co-infected patients with higher CD4 cell count, suggesting that T-cell cytolytic activity against HBV may still be effective in clearing HBV infection.
-end-
Reference: Psevdos G Jr, Kim JH, Suh JS, Sharp VL. Predictors of loss of hepatitis B surface antigen in HIV-infected patients. World J Gastroenterol 2010; 16(9): 1093-1096 http://www.wjgnet.com/1007-9327/16/1093.asp

Correspondence to: Dr. Jong Hun Kim, Division of Infectious Diseases, University of Pittsburgh Medical Center, Falk Medical Building, Ste 3A, 3601 Fifth Avenue, Pittsburgh, PA 15213-2582, United States. kimj4@upmc.edu

Telephone: +1-412-6486406 Fax: +1-412-6486399

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

World Journal of Gastroenterology

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.