Background: HIV-1 infection impairs cellular immunity, causing a detrimental effect on the natural course of hepatitis B virus (HBV) infection. HBV vaccination is less effective in HIV-1-infected patients. This study aimed to gain insight into HIV-1 infection with persistence of hepatitis B surface antigen (HBsAg) defining chronic hepatitis B infection (CBI) after a primary infection and the possible associated factors.Setting: Division of Infectious Diseases, San Raffaele Hospital, Italy. Methods: This retrospective study analyzed HIV-1-infected patients diagnosed with acute hepatitis B infection (AHB) based on clinical or laboratory records. CBI was defined as a positive HBsAg result recorded >6 months after an AHB diagnosis. Multivariate logistic regression was applied to assess factors (evaluated at AHB diagnosis) that were associated with CBI. Results: Of 63 HIV-1-infected patients with AHB, 23 (36.5%) developed CBI. On multivariate analysis, CBI risk was less likely in patients with HIV-RNA of >50 copies/mL (adjusted odds ratio = 0.03, 95% confidence interval: 0.001 to 0.58, P = 0.021). Dually acting antiretroviral treatment, including one or more drugs active against HIV/HBV (lamivudine, emtricitabine, and tenofovir), seemed to be protective in terms of the clinical outcome of CBI (adjusted odds ratio = 0.07, 95% confidence interval: 0.01 to 1.02, P = 0.050). Among the 23 patients with CBI, 15 (65.2%) lost the hepatitis B e-antigen, while 11 (47.8%) had HBsAg seroclearance during follow-up. Conclusions: In HIV-1-infected subjects with AHB, the persistence of HBsAg seemed to occur frequently. Factors associated with a lower CBI risk were detectable HIV load and the use of dually acting antiretroviral treatment during AHB.

Brief Report: Outcome of Acute Hepatitis B Virus Infection in HIV-1-Infected Patients: Possible Factors Associated with Resolution or Chronicity / Morsica, G.; Galli, L.; Bossolasco, S.; Bagaglio, S.; Vercesi, R.; Salpietro, S.; Hasson, H.; Messina, E.; Castagna, A.; Uberti-Foppa, C.. - In: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. - ISSN 1525-4135. - 82:2(2019), pp. 175-180. [Epub ahead of print] [10.1097/QAI.0000000000002106]

Brief Report: Outcome of Acute Hepatitis B Virus Infection in HIV-1-Infected Patients: Possible Factors Associated with Resolution or Chronicity

Castagna A.;Uberti-Foppa C.
2019-01-01

Abstract

Background: HIV-1 infection impairs cellular immunity, causing a detrimental effect on the natural course of hepatitis B virus (HBV) infection. HBV vaccination is less effective in HIV-1-infected patients. This study aimed to gain insight into HIV-1 infection with persistence of hepatitis B surface antigen (HBsAg) defining chronic hepatitis B infection (CBI) after a primary infection and the possible associated factors.Setting: Division of Infectious Diseases, San Raffaele Hospital, Italy. Methods: This retrospective study analyzed HIV-1-infected patients diagnosed with acute hepatitis B infection (AHB) based on clinical or laboratory records. CBI was defined as a positive HBsAg result recorded >6 months after an AHB diagnosis. Multivariate logistic regression was applied to assess factors (evaluated at AHB diagnosis) that were associated with CBI. Results: Of 63 HIV-1-infected patients with AHB, 23 (36.5%) developed CBI. On multivariate analysis, CBI risk was less likely in patients with HIV-RNA of >50 copies/mL (adjusted odds ratio = 0.03, 95% confidence interval: 0.001 to 0.58, P = 0.021). Dually acting antiretroviral treatment, including one or more drugs active against HIV/HBV (lamivudine, emtricitabine, and tenofovir), seemed to be protective in terms of the clinical outcome of CBI (adjusted odds ratio = 0.07, 95% confidence interval: 0.01 to 1.02, P = 0.050). Among the 23 patients with CBI, 15 (65.2%) lost the hepatitis B e-antigen, while 11 (47.8%) had HBsAg seroclearance during follow-up. Conclusions: In HIV-1-infected subjects with AHB, the persistence of HBsAg seemed to occur frequently. Factors associated with a lower CBI risk were detectable HIV load and the use of dually acting antiretroviral treatment during AHB.
2019
acute hepatitis B
chronic hepatitis B infection
dually acting antiretroviral treatment
HIV-1
Acute Disease
Adult
CD4 Lymphocyte Count
Female
HIV Infections
Hepatitis B Surface Antigens
Hepatitis B, Chronic
Humans
Logistic Models
Male
Retrospective Studies
Viral Load
HIV-1
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/105638
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