Occult hepatitis B virus infection in a Cohort of HIV-positive patients: Correlation with hepatitis C virus coinfection, virological and immunological features

G. Morsica, F. Ancarani, S. Bagaglio, M. Maracci, P. Cicconi, A. Cozzi Lepri, G. Antonucci, R. Bruno, T. Santantonio, L. Tacconi, F. Baldelli, R. Piscopo, D. Santoro, A. Lazzarin, A. D'Arminio Monforte

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Abstract

Background: : An evaluation of the prevalence of occult hepatitis B virus (HBV) infection in HIV-positive individuals is important as HBV infection may have an impact on the outcome of the liver disease in these patients. Materials and Methods: : Of the 1,593 HIV-positive subjects enrolled in the Italian Cohort Naïve Antiretroviral (ICONA) program, 175 (10.9%) were selected for inclusion in the study on the basis of hepatitis B surface antigen (HBsAg) negativity and antibody to hepatitis B core antigen (anti- HBc) positivity; 101/175 (58%) were also anti-hepatitis C virus (HCV) positive. HBV-DNA was detected in plasma using a highly sensitive PCR assay (detection limit: 2.6 copies/ml). Two different genomic regions were assayed. Quantification was performed by real-time PCR. The HBV genotype was determined in 20 cases with occult HBV infection. Data on the antiretroviral therapy (ART) regimen was obtained in 169 individuals: 53 (31.4%) patients were ART-naive, 46 (27.2%) were under ART without lamivudine or tenofovir, and the remaining 70 (41.4%) were under ART including lamivudine or tenofovir. Results: : 27/175 (15%) patients had detectable HBV-DNA in their plasma: 21/101 (21%) were anti-HCV positive and 6/74 (8%) were anti-HCV negative. Genotype D was invariably found in the 20 cases analyzed. Occult HBV infection was significantly higher in HCV-coinfected subjects: adjusted OR 5.02, 95% CI 1.31-19.26, p = 0.02. The value was not associated with immune status, HIV load, or ART regimen. Conclusions: : In relation to the high prevalence of occult HBV infection, particularly in HIV/HCV-coinfected individuals, it is necessary to clarify the clinical impact of this cryptic infection by monitoring HBV-DNA in plasma using the correct approach. Similarly to HBsAg-positive individuals of the Mediterranean area, HBV genotype D is invariably detected in this cohort of HIV-infected patients with occult HBV infection.

Original languageEnglish
Pages (from-to)445-449
Number of pages5
JournalInfection
Volume37
Issue number5
DOIs
Publication statusPublished - Oct 2009

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Virus Diseases
Coinfection
Hepatitis B virus
Hepacivirus
HIV
Tenofovir
Lamivudine
Genotype
Hepatitis B Surface Antigens
DNA
Hepatitis B Core Antigens
Therapeutics
Limit of Detection
HIV-1
Liver Diseases
Real-Time Polymerase Chain Reaction
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Occult hepatitis B virus infection in a Cohort of HIV-positive patients : Correlation with hepatitis C virus coinfection, virological and immunological features. / Morsica, G.; Ancarani, F.; Bagaglio, S.; Maracci, M.; Cicconi, P.; Cozzi Lepri, A.; Antonucci, G.; Bruno, R.; Santantonio, T.; Tacconi, L.; Baldelli, F.; Piscopo, R.; Santoro, D.; Lazzarin, A.; D'Arminio Monforte, A.

In: Infection, Vol. 37, No. 5, 10.2009, p. 445-449.

Research output: Contribution to journalArticle

Morsica, G, Ancarani, F, Bagaglio, S, Maracci, M, Cicconi, P, Cozzi Lepri, A, Antonucci, G, Bruno, R, Santantonio, T, Tacconi, L, Baldelli, F, Piscopo, R, Santoro, D, Lazzarin, A & D'Arminio Monforte, A 2009, 'Occult hepatitis B virus infection in a Cohort of HIV-positive patients: Correlation with hepatitis C virus coinfection, virological and immunological features', Infection, vol. 37, no. 5, pp. 445-449. https://doi.org/10.1007/s15010-008-8194-9
Morsica, G. ; Ancarani, F. ; Bagaglio, S. ; Maracci, M. ; Cicconi, P. ; Cozzi Lepri, A. ; Antonucci, G. ; Bruno, R. ; Santantonio, T. ; Tacconi, L. ; Baldelli, F. ; Piscopo, R. ; Santoro, D. ; Lazzarin, A. ; D'Arminio Monforte, A. / Occult hepatitis B virus infection in a Cohort of HIV-positive patients : Correlation with hepatitis C virus coinfection, virological and immunological features. In: Infection. 2009 ; Vol. 37, No. 5. pp. 445-449.
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abstract = "Background: : An evaluation of the prevalence of occult hepatitis B virus (HBV) infection in HIV-positive individuals is important as HBV infection may have an impact on the outcome of the liver disease in these patients. Materials and Methods: : Of the 1,593 HIV-positive subjects enrolled in the Italian Cohort Na{\"i}ve Antiretroviral (ICONA) program, 175 (10.9{\%}) were selected for inclusion in the study on the basis of hepatitis B surface antigen (HBsAg) negativity and antibody to hepatitis B core antigen (anti- HBc) positivity; 101/175 (58{\%}) were also anti-hepatitis C virus (HCV) positive. HBV-DNA was detected in plasma using a highly sensitive PCR assay (detection limit: 2.6 copies/ml). Two different genomic regions were assayed. Quantification was performed by real-time PCR. The HBV genotype was determined in 20 cases with occult HBV infection. Data on the antiretroviral therapy (ART) regimen was obtained in 169 individuals: 53 (31.4{\%}) patients were ART-naive, 46 (27.2{\%}) were under ART without lamivudine or tenofovir, and the remaining 70 (41.4{\%}) were under ART including lamivudine or tenofovir. Results: : 27/175 (15{\%}) patients had detectable HBV-DNA in their plasma: 21/101 (21{\%}) were anti-HCV positive and 6/74 (8{\%}) were anti-HCV negative. Genotype D was invariably found in the 20 cases analyzed. Occult HBV infection was significantly higher in HCV-coinfected subjects: adjusted OR 5.02, 95{\%} CI 1.31-19.26, p = 0.02. The value was not associated with immune status, HIV load, or ART regimen. Conclusions: : In relation to the high prevalence of occult HBV infection, particularly in HIV/HCV-coinfected individuals, it is necessary to clarify the clinical impact of this cryptic infection by monitoring HBV-DNA in plasma using the correct approach. Similarly to HBsAg-positive individuals of the Mediterranean area, HBV genotype D is invariably detected in this cohort of HIV-infected patients with occult HBV infection.",
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T1 - Occult hepatitis B virus infection in a Cohort of HIV-positive patients

T2 - Correlation with hepatitis C virus coinfection, virological and immunological features

AU - Morsica, G.

AU - Ancarani, F.

AU - Bagaglio, S.

AU - Maracci, M.

AU - Cicconi, P.

AU - Cozzi Lepri, A.

AU - Antonucci, G.

AU - Bruno, R.

AU - Santantonio, T.

AU - Tacconi, L.

AU - Baldelli, F.

AU - Piscopo, R.

AU - Santoro, D.

AU - Lazzarin, A.

AU - D'Arminio Monforte, A.

PY - 2009/10

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N2 - Background: : An evaluation of the prevalence of occult hepatitis B virus (HBV) infection in HIV-positive individuals is important as HBV infection may have an impact on the outcome of the liver disease in these patients. Materials and Methods: : Of the 1,593 HIV-positive subjects enrolled in the Italian Cohort Naïve Antiretroviral (ICONA) program, 175 (10.9%) were selected for inclusion in the study on the basis of hepatitis B surface antigen (HBsAg) negativity and antibody to hepatitis B core antigen (anti- HBc) positivity; 101/175 (58%) were also anti-hepatitis C virus (HCV) positive. HBV-DNA was detected in plasma using a highly sensitive PCR assay (detection limit: 2.6 copies/ml). Two different genomic regions were assayed. Quantification was performed by real-time PCR. The HBV genotype was determined in 20 cases with occult HBV infection. Data on the antiretroviral therapy (ART) regimen was obtained in 169 individuals: 53 (31.4%) patients were ART-naive, 46 (27.2%) were under ART without lamivudine or tenofovir, and the remaining 70 (41.4%) were under ART including lamivudine or tenofovir. Results: : 27/175 (15%) patients had detectable HBV-DNA in their plasma: 21/101 (21%) were anti-HCV positive and 6/74 (8%) were anti-HCV negative. Genotype D was invariably found in the 20 cases analyzed. Occult HBV infection was significantly higher in HCV-coinfected subjects: adjusted OR 5.02, 95% CI 1.31-19.26, p = 0.02. The value was not associated with immune status, HIV load, or ART regimen. Conclusions: : In relation to the high prevalence of occult HBV infection, particularly in HIV/HCV-coinfected individuals, it is necessary to clarify the clinical impact of this cryptic infection by monitoring HBV-DNA in plasma using the correct approach. Similarly to HBsAg-positive individuals of the Mediterranean area, HBV genotype D is invariably detected in this cohort of HIV-infected patients with occult HBV infection.

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