Incident Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Men Who Have Sex with Men from Pre-HAART to HAART Periods

Men who have sex with men (MSM) are at high risk for hepatitis B virus (HBV) infection. Data on the effect of highly active antiretroviral therapy (HAART) on incident HBV infection in HIV-infected and HIV-uninfected MSM are limited.

To determine predictors of incident HBV infection in MSM during pre-HAART and HAART periods.

Patients: 2375 HBV-uninfected MSM in the Multicenter AIDS Cohort Study.

Poisson regression was used to compare incidence rates of HBV infection in the pre-HAART and HAART eras and to identify factors associated with incidence of HBV infection.

In 25 322 person-years of follow-up, 244 incident HBV infections occurred. The unadjusted incidence rate was higher in HIV-infected MSM than in HIV-uninfected MSM and was significantly lower in the HAART era than in the pre-HAART era among HIV-infected and HIV-uninfected MSM. Age younger than 40 years, more than 1 recent sexual partner, and HIV infection were independently associated with higher incidence of HBV infection, whereas HBV vaccination was protective. Highly active antiretroviral therapy with HIV RNA levels less than 400 copies/mL was associated with protection, but HAART in those with HIV RNA levels of 400 copies/mL or greater was not.

Effective HAART is associated with lower incidence of HBV infection; however, even in the HAART era, incidence of HBV infection remains high among MSM.

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By: Falade-Nwulia O, Seaberg EC, Snider AE, Rinaldo CR, Phair J, Witt MD, Thio CL.

From Johns Hopkins University, Baltimore, Maryland; University of Pittsburgh, Pittsburgh, Pennsylvania; Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and Los Angeles Biomedical Research Institute at Harbor–University of California, Los Angeles Medical Center, Torrance, California.
  

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