Very low prevalence and no clinical significance of occult hepatitis B in a cohort of HIV-infected patients with isolated anti-HBc seropositivity: the BHOI study

• Published in: HIV clinical trials Vol. 9; no. 5; p. 337
• Main Authors: Palacios, R, Mata, R, Hidalgo, A, Muñoz, L, Viciana, I, Del Arco, A, López-Cortés, L F, Peña, A, de la Torre, J, Santos, J
• Format: Journal Article
• Language: English
• Published: England 01.09.2008
• Subjects: Adult; Antiretroviral Therapy, Highly Active; Cross-Sectional Studies; Female; Hepatitis B - epidemiology; Hepatitis B - etiology; Hepatitis B - immunology; Hepatitis B Antibodies - blood; Hepatitis B Surface Antigens - blood; HIV Infections - complications; HIV Infections - drug therapy; Humans; Male; Middle Aged; Prevalence
• ISSN: 1528-4336; 1945-5771
• DOI: 10.1310/hct0905-337

Data on occult HBV infection in HIV patients are conflicting. We aimed to analyse the prevalence and clinical significance of occult hepatitis B in HIV-infected subjects. An open-label, cross-sectional, multicentre study including all subjects with isolated anti-HBc seropositivity from a cohort of 3,030 HIV-infected patients was undertaken. HBsAg and HBsAb were both negative in all cases, and those patients with acute or convalescent hepatitis B were excluded. HBV DNA was quantified by PCR with a detection limit of 20 IU/mL. We found 5 cases (2.5%) of occult hepatitis B among 202 HIV-patients with isolated anti-HBc. The mean HBV DNA was 66 (15-112) IU/mL, none had symptomatic hepatitis, and their features, including aminotransferase levels, were similar to those without occult HBV infection. Occult hepatitis due to HBV is very unusual in HIV-positive patients with isolated anti-HBc. The use of standard regimens of HAART including drugs with activity against HBV might underestimate the prevalence of occult HBV infection. These patients had a very low viral load, no identifiable risk factors, and no greater risk of hypertransaminasaemia or the development of symptomatic hepatitis.