Role of genotype G hepatitis B virus mixed infection on the progression of hepatic fibrosis in HIV positive patients over 5 years of follow-up

J Clin Virol. 2013 Oct;58(2):408-14. doi: 10.1016/j.jcv.2013.07.018. Epub 2013 Aug 6.

Abstract

Background: Due to common routes of transmission, HIV and HBV are frequently found as concomitant infections. The dynamic of liver disease in co-infected patients is important to understand for appropriate clinical management. Conflicting data surround the role played by genotype-G HBV (HBV-G) during the course of HIV co-infection.

Objectives: This study aims to assess, using non-invasive methods, liver disease progression in HIV-HBV genotype-G co-infected patients.

Study design: Co-infected patients with residual HBV replication (n=125) were screened for HBV-G infection by specific real-time PCR. The impact of HBV-G on liver fibrosis progression, as assessed by a non invasive biomarker (Fibrotest), was evaluated first, by a cross sectional analysis comparing fibrosis between HBV-G (n=23) and non-G (n=55) infected patients and second, by a longitudinal study performed over a 5 year period.

Results: Selected patients were mostly male (90%), with homogenous characteristics between the HBV-G and non-G infected groups, in terms of age, known duration of HIV disease, immune and virological status and duration of HIV/HBV treatment. HBV-G infected patients were exclusively from Western Europe with homosexual intercourses (83%) as principal risk of transmission. Cross sectional analysis revealed comparable liver disease severity distribution between HBV-G and non-G infected patients. Co-infection with other hepatitis viruses and low CD4-nadir, but not HBV-G co-infection, were associated with a 5-year risk of fibrosis progression.

Conclusions: This study suggests that HBV-G infection is not significantly associated with a more severe liver disease and does not have a deleterious impact on fibrosis progression in efficiently treated HIV-HBV co-infected patients.

Keywords: HBV–HIV co-infection; Men having sex with men; Non-invasive biomarker; Real-time PCR; Risk factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Coinfection / complications*
  • Disease Progression
  • Europe
  • Female
  • Genotype
  • HIV Infections / complications*
  • Hepatitis B virus / classification
  • Hepatitis B virus / genetics*
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / virology
  • Humans
  • Liver Cirrhosis / epidemiology*
  • Liver Cirrhosis / pathology*
  • Male
  • Middle Aged
  • Real-Time Polymerase Chain Reaction