Association between Syphilis, Antibodies to Herpes Simplex Virus Type 2, and Recreational Drug Use and Hepatitis B Virus Infection in the Women's Interagency HIV Study

• Published in: Clinical infectious diseases Vol. 39; no. 9; pp. 1363 - 1370
• Main Authors: Tien, Phyllis C., Kovacs, Andrea, Bacchetti, Peter, French, Audrey L., Augenbraun, Michael, Cole, Stephen R., Hessol, Nancy, Justman, Jessica
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.11.2004; University of Chicago Press
• Subjects: Adult; Antibodies; Antibodies, Viral - blood; Antivirals; Bacterial diseases; Bacterial diseases of the genital system; Biological and medical sciences; Cohort Studies; Female; Hepatitis B; Hepatitis B - epidemiology; Hepatitis B virus; Herpes simplex virus 2; Herpesvirus 2, Human - immunology; HIV; HIV infections; HIV Infections - epidemiology; HIV/AIDS; Human bacterial diseases; Human immunodeficiency virus; Human viral diseases; Humans; Illicit drugs; Infections; Infectious diseases; Injections; Medical sciences; Multivariate Analysis; Risk Factors; Seroepidemiologic Studies; Substance Abuse, Intravenous - epidemiology; Syphilis - epidemiology; Vaccination; Viral diseases; Viral diseases of the digestive system; Viral hepatitis; Prognosis; Prevalence; Alphaherpesvirinae; Orthohepadnavirus; Hepatic disease; Serology; Epidemiology; Case history; Viral hepatitis B; Prevention; Hepadnaviridae; Spirochaetosis; Syphilis; Human herpesvirus 2; Female; Hepatitis B virus; Woman; Human; Immunopathology; Drug addiction; Hepatitis B core antigen; Antibody; Herpesviridae; Mortality; Use; Retroviridae; AIDS; Vaccine; Method; Immune deficiency; Lentivirus; Treponematosis; Infection; Virus; Immunoprophylaxis; Sexually transmitted disease; Viral disease; Risk factor; Bacteriosis; Digestive diseases; Human immunodeficiency virus; Predictive factor
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/424879

Background. Liver disease is a leading cause of death in human immunodeficiency virus (HIV)–infected women; however, risk factors for hepatitis B virus (HBV) infection in this population have not been well studied. Methods. We describe the seroprevalence and predictors of HBV infection in a cross-sectional analysis of 2132 women with and at risk for HIV infection enrolled in the Women's Interagency HIV Study during the periods 1994–95 and 2001–02. Any test result positive for antibody to hepatitis B core antigen defined infection; those women with serological evidence of vaccine immunity were excluded from analysis. Women were stratified into those with a history of injection drug use (IDU), those with a history of noninjection drug use (non-IDU), and those with no history of illicit drug use. Results. Of 1606 HIV-infected and 526 HIV-uninfected women, 7% and 12%, respectively, appeared to be vaccine immune. After exclusion of these women, 43% of 1500 HIV-infected and 22% of 461 HIV-uninfected women had HBV infection. HBV infection prevalence differed among the IDU, non-IDU, and no illicit drug use groups (76%, 30%, and 17%, respectively; P < .0001). HBV infection was strongly associated with herpes simplex virus 2 (HSV-2) seropositivity in the IDU group (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.6–5.4) and with a history of syphilis in the non-IDU group (OR, 2.7; 95% CI, 1.4–5.0). Discussion. We found a high prevalence of HBV infection in our cohort of women with and at risk for HIV infection. HSV-2 seropositivity and a history of syphilis appeared to be important correlates of HBV infection. Sexual transmission of HBV, particularly in those with a history of genital ulcer disease, should be a major focus of education in all high-risk groups.