HIV Through the Looking Glass: Insights Derived From Hepatitis B. (1st February 2015)

• Record Type: Journal Article
• Authors: Rivera, Maria M.; Soza, Alejandro; Jazwinski, Alison; Mi, Lijun; Kleiner, David E.; Zhao, Xiongce; Zuber, Charma; Brust, Douglas; Hsu, Emory; Simpson, Jennifer; Hoofnagle, Jay H.; Heller, Theo
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 68:Number 2(2015)
• Publication Date: 2015-02-01
• Subjects: co-infection -- HBV -- HIV -- immune; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000000415
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: Although higher levels of hepatitis B virus (HBV) replication in HIV-HBV co-infection may relate to liver disease progression, this has not been completely elucidated. We used expression of hepatitis B core antigen (HBcAg) in liver biopsies from HIV-HBV co-infected and HBV mono-infected patients as a marker for HBV replication, and related these findings to clinical and histological parameters. Methods: Data from 244 HBV patients were compared with 34 HIV-HBV patients. Liver biopsies were scored for inflammation, fibrosis, HBcAg, and hepatitis B surface antigen. Univariate and multivariate analyses were performed. Results: HBcAg, but not hepatitis B surface antigen, staining was stronger in HIV co-infected than in HBV mono-infected. Co-infected and HBV mono-infected had similar alanine aminotransferase, inflammatory and fibrosis scores, and hepatitis B e antigen status. HBcAg staining correlated with HIV after correcting for HBV DNA and hepatitis B e antigen. CD4 counts and HIV RNA level did not correlate with intensity of HBcAg staining. HBV DNA levels were higher in HIV co-infected and correlated with HBcAg staining. Conclusions: By looking at HBcAg as a reflection of HBV replication in HIV-HBV co-infected with controlled HIV, our findings suggest that these patients may have subtle immune function defects, which could lead to adverse liver disease outcomes. Abstract : Supplemental Digital Content is Available in the Text.