Incident Hepatitis B in Men with or at Risk for HIV Infection

描述（由申请方提供）：本提案重点关注多中心艾滋病队列研究（MACS）中男性的偶发性B型肝炎病毒（HBV）感染，该研究是一项针对男男性行为者（MSM）的研究。特别是，这些目标包括确定在HAART前和HAART时代HIV感染和HIV未感染男性中HBV感染的趋势，并确定与这些感染的各种结果相关的因素。这些目标的实现是非常重要的，因为肝脏疾病是HIV感染者发病和死亡的重要原因，这些数据将提供信息，将公共卫生工作的重点放在预防HBV传播上。第一个目标确定了不同5年期间新发HBV感染的发生率，包括HAART前、早期HAART和后期HAART期间，以确定HIV感染和HIV未感染MSM的发生率如何随时间变化。自从高效抗逆转录病毒疗法变得更有效以来，其他性传播疾病在这一人群中一直在增加，但关于HBV发病率的数据并不存在。这些数据对该人群的公共卫生工作非常重要。第二个目标将确定是否正在发生耐药HBV的传播。MACS是研究这一点的理想人群，因为许多HIV感染的男性正在服用HIV药物，这些药物也对HBV有活性，HBV是最有可能感染耐药变体的群体。第三个目的是确定HAART前和HAART时代与急性HBV感染恢复相关的因素。第四个目标将确定血清逆转的频率和与血清逆转相关的因素。总之，这项研究将产生重要的信息，以了解目前的HBV流行之间的男男性接触者，以更有效地针对公共卫生工作。

DESCRIPTION (provided by applicant): This proposal focuses on incident hepatitis B virus (HBV) infections in men in the Multicenter AIDS Cohort Study (MACS), which is a study of men who have sex with men (MSM). In particular, the goals include determining trends in incident HBV infections in HIV-infected and HIV-uninfected men during the pre-HAART and HAART eras and determining factors associated with various outcomes of these infections. These goals are important to achieve since liver disease is an important cause of morbidity and mortality in HIV-infected persons and these data will provide information to focus public health efforts on prevention of HBV transmission. The first Aim determines the incidence of new HBV infections during distinct 5 year periods that cover the pre- HAART, early HAART, and later HAART periods in order to determine how the incidence has changed over time in HIV-infected and HIV-uninfected MSM. Other sexually transmitted diseases have been increasing in this population since HAART has become more effective but data on HBV incidence do not exist. These data are important for public health efforts in this population. The second Aim will determine whether transmission of drug-resistant HBV is occurring. The MACS is an ideal population to study this since many of the HIV- infected men are on HIV drugs that are also active against HBV, which is the group most likely to be infected with a drug-resistant variant. The third Aim is designed to determine factors associated with recovery from an acute HBV infection in the pre-HAART and the HAART eras. The fourth Aim will determine the frequency of seroreversion and the factors associated with seroreversion. In summary, this study will yield important information to understand the current HBV epidemic amongst MSM in order to target public health efforts more efficiently.