Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Mar 7, 2010; 16(9): 1093-1096
Published online Mar 7, 2010. doi: 10.3748/wjg.v16.i9.1093
Predictors of loss of hepatitis B surface antigen in HIV-infected patients
George Psevdos Jr, Jong Hun Kim, Jin S Suh, Victoria Lee Sharp
George Psevdos Jr, Jin S Suh, Center for Comprehensive Care, Division of Infectious Diseases, St. Luke’s-Roosevelt Hospital Center, New York, NY 10019, United States
Jong Hun Kim, Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
Victoria Lee Sharp, Center for Comprehensive Care, St. Luke’s-Roosevelt Hospital Center, New York, NY 10019, United States
Author contributions: Psevdos G Jr and Kim JH contributed equally to this work; Kim JH and Psevdos G Jr designed the research; Kim JH performed the research and analyzed the data; Kim JH and Psevdos G Jr wrote the paper; Psevdos G Jr, Suh JS and Sharp VL supervised the whole study.
Correspondence to: Dr. Jong Hun Kim, Division of Infectious Diseases, University of Pittsburgh Medical Center, Falk Medical Building, Ste 3A, 3601 Fifth Avenue, Pittsburgh, PA 15213-2582, United States. kimj4@upmc.edu
Telephone: +1-412-6486406 Fax: +1-412-6486399
Received: June 26, 2009
Revised: December 8, 2009
Accepted: December 15, 2009
Published online: March 7, 2010
Abstract

AIM: To study factors associated with loss of hepatitis B surface antigen (HBsAg) in patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV).

METHODS: We retrospectively reviewed the medical records of 5681 patients followed up at two New York City HIV clinics from January 1999 to May 2007. Clinical and laboratory parameters including baseline and follow-up HIV viral loads, CD4 cell counts, alanine transaminase levels, demographics, presence of hepatitis C infection, and treatment with highly active antiretroviral therapy dually active against both HIV and HBV infection, were analyzed to determine factors associated with loss of HBsAg.

RESULTS: Three hundred and fifty five patients (355/5681, 6.84%) were co-infected with HIV and HBV and were evaluated. Of these, 226 patients with more than 12 mo follow-up were included in further analysis to determine factors associated with loss of HBsAg in the long-term follow-up. In the univariate analysis, baseline CD4 cell count was associated with loss of HBsAg (P = 0.052). Cox regression analysis revealed that loss of HBsAg was associated with baseline CD4 cell count > 500 cells/mm3 (P = 0.016, odds ratio: 76.174, 95% confidence interval: 2.233-2598.481).

CONCLUSION: Our study showed an interesting association of loss of HBsAg in HIV-HBV co-infected patients with higher CD4 cell count, suggesting that T-cell cytolytic activity against HBV may still be effective in clearing HBV infection.

Keywords: Human immunodeficiency virus; Hepatitis B; Viral antigens; Surface antigens