By Liz Highleyman

Due to overlapping routes of transmission, many HIV positive people have been exposed to hepatitis B virus (HBV). While most are able to spontaneously clear HBV without treatment, the likelihood of developing chronic hepatitis B is higher in HIV positive compared with HIV negative individuals.

As presented this week at the 48th International Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2008) in Washington, DC, researchers calculated the prevalence of chronic HBV infection annually from 1996 through 2006 according to age, sex, race/ethnicity, and HIV risk factors among participants in the HIV Outpatient Study (HOPS), a U.S. multisite observational cohort study of HIV-infected patients.

HBV prevalence was defined as the number of patients with positive hepatitis B surface antigen (HBsAg) or hepatitis B "e" antigen (HBeAg) or detectable HBV DNA divided by the number of patients tested for chronic HBV infection.

Results

• Of the 7050 patients in the HOPS cohort during the 1996-2006 period, 4315 (61.2%) were tested for chronic HBV infection.

• Of these, 369 (8.6%) were positive for HBsAg or HBeAg or had detectable HBV DNA.

• Annual chronic HBV infection prevalence ranged from 8.0% to 8.7% over the study period.

• During this period, there was a downward trend in HBV prevalence, but it did not reach statistical significance.

• HBV prevalence was highest among patients aged 40-49 years, men, and men who have sex with men.

The investigators concluded that "The prevalence of chronic HBV infection in the HOPS [cohort] was unchanged over the past decade among patients in all demographic and HIV risk groups," although the overall prevalence was "20 times greater than national prevalence estimates" for the general HIV negative population (0.42%).

"Although HBV infection treatment options now exist for coinfected patients, vaccination of persons at risk for HBV infection remains the most essential intervention," they emphasized.

[Figure taken from abstract, PR Spradling et al.]

CDC, Atlanta, GA; Cerner Corp., Vienna,VA.

10/31/08

Reference
PR Spradling, IT Richardson, K Buchacz, and others (HIV Outpatient Study Investigators). Chronic Hepatitis B Virus (HBV) Infection in the HIV Outpatient Study, 1996-2006: Prevalence in the Era of Evolving Interventions. 48th International Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2008). Washington, DC. October 25-28, 2008. Abstract V-1622.