Liver Disease and Survival Outcomes in HIV-HBV Coinfected Individuals Although
a large percentage of HIV positive people
show evidence of past or current infection with hepatitis
B virus (HBV), the impact of chronic hepatitis B and the presence of isolated
HBV core antibodies (anti-HBc) on survival in HAART
era has not been extensively studied.
As reported in the July 2007
issue of HIV Medicine, researchers conducted a retrospective analysis of
1685 patients from the HIV Atlanta Veterans Affairs Cohort Study (HAVACS) who
had available HBV serology data.
Adjusted survival analyses were performed
for patients showing any of 4 serological patterns for HBV:
•
HBV surface antigen positive (indicating chronic HBV infection);
•
Isolated HBV core antibodies;
•
HBV surface antibodies, with or without core antibodies (indicating resolved infection
or HBV vaccination);
•
No detectable HBV markers (HBV negative).
Results
•
A trend was observed for a lower survival rate from the time of AIDS diagnosis
to death in the group with chronic HBV infection compared with the HBV negative
group (hazard ratio [HR] 1.43).
•
The only independent predictor of reduced survival was hepatitis C virus (HCV)
positivity (HR 1.62).
•
Protective factors were use of any HAART (HR 0.40), use of lamivudine (Epivir)
(HR 0.36), and use of tenofovir (Viread) (HR 0.23).
•
Survival from HIV diagnosis to death did not differ among the HBV groups.
•
Patients with isolated HBV core antibodies did not have a lower survival rate
compared to those with resolved HBV infection.
•
Patients with chronic HBV infection were 3.5 times more likely to have liver disease
than those with no of HBV infection.
Conclusion
"There
is a trend towards a lower survival rate in patients with HIV
and chronic HBV infection, but the difference did not reach statistical significance,"
the authors concluded. "The presence of isolated core antibody was not associated
with a lower survival rate."
08/17/07 Reference
MK
Osborn, JL Guest, and D Rimland. Hepatitis B virus and HIV coinfection: relationship
of different serological patterns to survival and liver disease. HIV Medicine
8(5): 271-279. July 2007.
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