Increased Detection of HBV DNA in HBsAg-Positive and HBsAg-Negative South African HIV/AIDS Patients Enrolling for Highly Active Antiretroviral Therapy at a Tertiary Hospital
Increased Detection of HBV DNA in HBsAg-Positive and HBsAg-Negative South African HIV/AIDS Patients Enrolling for Highly Active Antiretroviral Therapy at a Tertiary Hospital
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DOI：
10.1002/jmv.21418
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发表时间：
2009-03-01
影响因子：
12.7
通讯作者：
Mphahlele, M. Jeffrey
中科院分区：
文献类型：
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作者：
Lukhwareni, Azwidowi;Burnett, Rosemary J.;Mphahlele, M. Jeffrey
本回顾性研究调查了192例南非人类免疫缺陷病毒（HIV）阳性患者开始抗逆转录病毒治疗（ART）的储存血清中B型肝炎病毒（HBV）的患病率，并探讨了HBV-HIV合并感染对HBV实验室诊断的影响。进行HBV血清学（HBsAg、抗-HBs和抗-HBc）和靶向HBV聚合酶基因的巢式HBV PCR检测，使用Cobas Taqman HBV test 48检测（Roche Diagnostics）定量HBV DNA阳性样本。研究发现，63%（121/192）的患者既往或目前有HBV感染，40.6%（78/192）的患者可检测到HBV DNA。22.9%（44/192）的患者HBsAg阳性，HBV DNA阳性，而23%（34/148）的HBsAg阴性患者存在隐匿性HBV感染。在78例HBV DNA阳性样本中，62.8%的病毒载量范围为10（2）至>= 10（8）IU/ml，37.2%的HBV病毒载量= 10（8）IU/ml，而HBsAg阴性样本仅为5.9%（2/34）（相对危险度：4.64; 95%置信区间：1.11，19.35;卡方P值= 0.015）。该研究表明，大多数开始ART的HIV/AIDS患者患有急性或慢性HBV感染，并进一步证实HIV仍然是南非患者隐性HBV感染的风险因素。研究结果强烈支持在南非所有开始ART的HIV阳性患者中进行HBV筛查，考虑到目前的ART方案包括具有抗HBV活性的药物（例如，拉米夫定）。J. Med. Virol. 81：406-412，2009年。(C)2009威利-利斯公司
This retrospective study investigated the prevalence of hepatitis B virus (HBV) in 192 stored sera from human immunodeficiency virus (HIV) positive South African patients initiating antiretroviral therapy (ART), and explored the implications of HBV-HIV co-infection on laboratory diagnosis of HBV. HBV serology (HBsAg, anti-HBs and anti-HBc) and nested HBV PCR assays targeting the HBV polymerase gene were performed, with HBV DNA positive samples being quantified with Cobas Taqman HBV test 48 assay (Roche Diagnostics). The study found that 63% (121/192) of patients had past or present HBV infection, and 40.6% (78/192) had detectable HBV DNA. Also, 22.9% (44/192) of patients were HBsAg positive and HBV DNA positive, while 23% (34/148) of HBsAG negatives had occult HBV infections. Of the 78 HBV DNA positive samples, 62.8% had viral loads ranging from 10(2) to >= 10(8) IU/ml, and 37.2% had HBV viral loads = 10(8) IU/ml, compared to only 5.9% (2/34) of HBsAg negatives (relative risk: 4.64; 95% confidence interval: 1.11, 19.35; chi-square P-value = 0.015). The study shows that the majority of HIV/AIDS patients initiating ART have either acute or chronic HBV infections, and further confirms that HIV remains a risk factor for occult HBV infections in South African patients as previously shown. The findings strongly support HBV screening in all HIV-positive patients initiating ART in South Africa, considering that current ART regimens include drugs with anti-HBV activity (e.g., lamivudine). J. Med. Virol. 81:406-412, 2009. (C) 2009 Wiley-Liss, Inc.