Prevalence of occult hepatitis B infection among HIV infected patients at an innercity clinic

Abstract

Considering higher morbidity and mortality associated with HIV/HBV coinfected patients compared to monoinfected patients, it is imperative to determine the prevalence of occult HBV (OHB) infection, in such population.630 unique HIV-infected patients, during the defined study period, were screened for evidence of occult HBV infection serology. 82 patients (13%) were found to have evidence suggestive of OHB infection of which 57 had HBV DNA testing available and comprised the final study population. Data on demographic variables, Hepatitis C antibody status, antiretroviral therapy (ARV), CD4 count and HIV viral load was also collected. Among the final study population, 7% (n=4) patients met the OHB definition. All 4 (100%) with OHB had HIV RNA levels > 50 copies/ml. OHB was found in 4 (22%) of 18 patients not on ARV, but in none of 39 patients on ARV (p=0.007). All patients on ARV were on a regimen with anti HBV activity. 75% of patients with OHB tested positive for HCV compared to 47% in isolated anti HBc positive but HBV DNA negative population (p= 0.58). With an OHB prevalence of 7% in our community clinic, clinicians should have a high index of suspicion for OHB among HIV patients whose hepatitis panel is positive only for anti HBc only and start them on HAART regimen containing ARVs with anti-HBV activity. © 2013 Nog R, et al.