Serological profile and virological evaluation of hepatitis B and hepatitis C virus infection among HIV-infected patients in Greece

Abstract number: 1134_01_298

Elefsiniotis I.S., Paparizos V., Mpotsi C., Pantazis K.D., Katsambas A.

Objectives:  

To evaluate the prevalence of serological markers of HBV and HCV infections among a large cohort of HIV-infected patients and to examine the serum levels of HBV-DNA and HCV-RNA in a subgroup of HIV/HBV and HIV/HCV coinfected patients respectively.

Methods:  

We retrospectively analysed 737 HIV-infected patients followed-up at the Department of Infectious Diseases, ‘Andreas Sygros’ University Hospital of Athens, Greece, since 1995, for the presence of serological markers of HBV and HCV infection. Virological evaluation (HBV-DNA, HCV-RNA) and HCV genotyping, before the initiation of ART, was available in a subgroup of HIV/HBV and HIV/HCV coinfected patients.

Results:  

Overall 88.6% (653/737) of the study population were men and 11.4% (84/727) women whereas the vast majority of them (453/737, 61.5%) were homosexual (HOM) men. Thirty-nine of 737 patients (5.3%) reported intravenous drug use (IVDU) and 17 of them were both HOM/IVDU. Among the 737 HIV-infected patients 89 (12.1%) were HBsAg(+) and the majority of them (54/89, 60.7%) were HBeAg(+) whereas 33.7% (30/89) of HBsAg(+)/HIV(+) patients were HBeAg(-)/anti- HBeAg(+). Anti-HBc seropositivity was detected in 48.1% (355/737) of the study population. The serum levels of HBV-DNA in this subpopulation with available virological data were 5.75 ± 1.66 (-log10 copies/ml) and HBeAg(+) HIV/HBV coinfected patients had significantly higher baseline serum HBV-DNA levels than HBeAg(-)/AntiHBe(+) coinfected ones (7.40 ± 0.64 vs 4.59 ± 1.01, -log10 copies/ml, respectively, p < 0.001). Fifty-one of 625 HIV-infected patients, of which anti-HCV test was available, were anti-HCV positive (8.2%). Quantitative calculation of HCV-RNA and HCV genotyping were available in 28 HIV(+)/anti-HCV(+) patients. The vast majority of them (24/28, 85.7%) had HCV-RNA levels more than 700.000 IU/L and the most common HCV-genotype was genotype-1 (12/28, 42.9%) followed by genotype-3 (10/28, 35.7%), genotype-4 (4/28, 14.3%) and genotype-2 (2/28, 7.1%). Five patients (0.68% of the total study population) exhibited triple infection (HIV/HCV/HBV).

Conclusion:  

HIV/HBV coinfection is observed in a significant proportion of HIV-infected patients in Greece and the majority of them are HBeAg (+), exhibiting extremely high HBV-DNA levels, in contrast to general Greek population. Genotype-1 and high HCV-RNA levels are the most common findings in HIV/HCV coinfected patients, characterizing a difficult to treat population.