Article
Prevalence and risk factors of Hepatitis B and C in treatment naïve HIV positive patients
Coinfektion mit Hepatitis B und C bei therapienaiven HIV-Patienten – Prävalenz und Risikofaktoren
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Published: | June 2, 2010 |
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Introduction: In HIV treatment-naïve patients we analyzed the prevalence of serological and molecular markers for hepatitis B virus (HBV) and hepatitis C virus (HCV). We aimed at the identification of risk factors for chronic or occult hepatitis B infection (oHBV) and HCV infection.
Patients, materials and methods: We included 918 treatment-naive HIV patients of the RESINA-cohort recruited from the University Hospitals in Cologne and Düsseldorf, Germany. Blood samples were analyzed immediately before start of HIV-treatment for antibodies against HIV, HBV and HCV, HBs-antigen and viral loads for HIV and HBV.
Results: Markers for present or past HBV infection (HBs-antigen and/or anti-HBc) were found in 398/918 patients (43.4%). HBs-antigen was detected in 41/918 (4.5%), HBV DNA in 34/554 patients (6.14%) and oHBV in 16 /554 cases (2.9%). Neither the presence of anti-HBs (8 /16) nor the absence of all HBV seromarkers (4/16) ruled out oHBV infection. Anti-HCV was found in 97/917 (10.6%) samples and 60 /913 (6.6%) had serological signs of co-infection with HBV. In a multivariate analysis, IV drug use (IVDU) increased the likelihood (odds) for a HCV positive serostatus by the factor 70 and an increase of the HI-viral load (HIVL) of 30,000 copies/ml decreased the likelihood by 0.9. Transmitted HIV resistance mutations were significantly correlated with active HBV infection (p=0.001) and with HCV positivity (p=0.028). Transmitted HBV associated mutations were significantly more often found in HCV positive patients (p=0.022).
Conclusions: Both HBV- and HCV-co-infections were frequent in HIV treatment-naive patients. Factors independently associated with HCV co-infection were IVDU and low HIVL. oHBV constituted almost half of all chronic HBV infections. Due to a lack of risk factors indicating oHBV, the determination of serological markers should routinely be accompanied by analysis of HBV DNA.