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

描述(由申请人提供)：这项建议集中在多中心艾滋病队列研究(MACS)中男性中发生的乙肝病毒(乙肝)感染，这是一项针对男男性行为(MSM)的研究。特别是，目标包括确定艾滋病毒感染者和未感染艾滋病毒的男性在HAART前和HAART时代发生的乙肝病毒感染的趋势，以及确定与这些感染的各种结果相关的因素。实现这些目标很重要，因为肝病是艾滋病毒感染者发病和死亡的重要原因，这些数据将提供信息，以便将公共卫生工作的重点放在预防乙肝病毒传播上。第一个目标是确定在HAART前、HAART早期和HAART后期的不同5年期间新的乙肝病毒感染的发生率，以确定感染艾滋病毒和未感染HIV的MSM的发病率随时间的变化。自从HAART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，但没有关于乙肝病毒发病率的数据。这些数据对这一人群的公共卫生工作很重要。第二个目标将确定是否正在发生耐药乙肝病毒的传播。Mac是研究这一问题的理想人群，因为许多感染艾滋病毒的男性服用的艾滋病毒药物也对乙肝病毒有效，而乙肝病毒是最有可能感染耐药变异的群体。第三个目标是确定在HAART前和HAART时代与急性乙肝病毒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，这项研究将提供重要信息，以了解当前男男性接触者中的乙肝流行情况，以便更有效地针对公共卫生努力。 公共卫生相关性：高达10%的艾滋病毒感染者同时感染艾滋病毒和乙肝病毒，这是一个重要的公共卫生问题，因为肝病是非艾滋病死亡的主要原因之一。因此，预防艾滋病毒感染者中发生的乙肝病毒是至关重要的，并需要了解急性乙肝病毒感染的传播趋势和与结果相关的因素。这项提案将提供这样的数据，这将有助于将公共卫生工作的重点放在预防艾滋病毒感染男性或有感染艾滋病毒风险的男性中。

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. PUBLIC HEALTH RELEVANCE: HIV-HBV co-infection occurs in up to 10% of HIV-infected individuals and is an important public health problem since liver disease is one of the leading causes of non-AIDS mortality. Thus, prevention of incident HBV in HIV-infected persons is essential and requires understanding the transmission trends and the factors associated with outcomes of acute HBV infections. This proposal will provide such data, which will help focus public health efforts in prevention of HBV infections in men with or at risk for HIV infection.