Background: Hepatitis B virus (HBV) RNA and hepatitis B core-related antigen (HBcrAg), reflecting transcriptional activity of covalently closed circular DNA, are gaining traction as important markers to assess viral activity. Whether their expression differs under viral suppression by HIV co-infection status is unknown. Aim: Among adults with chronic HBV on antiviral therapy, we sought to determine if the expression of HBV markers (specialized and well-established) differ between HBV-HIV co-infection vs. HBV mono-infection. Methods: We compared HBV marker levels among 105 participants in the Hepatitis B Research Network (HBRN) HBV-HIV Ancillary Study and 105 participants in the HBRN mono-infected Cohort Study, matched for HBeAg status and HBV DNA suppression on therapy. Results: Among HBeAg+ participants (N=58 per group), after adjusting for age, sex, race, ALT and HBV DNA, viral markers were higher (p<.05) in the HBV-HIV versus the HBV-only sample (HBeAg: 1.05 vs. 0.51 log 10} IU/mL; HBsAg: 3.85 vs. 3.17 log 10} IU/mL; HBV RNA: 5.60 vs. 3.70 log 10} U/mL; HBcrAg: 6.59 vs. 5.51 log 10} U/mL). Conversely, among HBeAg(−) participants (N=47 per group), HBsAg (2.00 vs. 3.04 log10 IU/mL) and HBV RNA (1.87 vs. 2.66 log 10} U/mL) were lower (p<.05) in HBV-HIV vs. HBV-only; HBcrAg levels were similar (4.14 vs. 3.64 log 10} U/mL; p=.27). Conclusion: Among adults with chronic HBV with suppressed viremia on antiviral therapy, viral markers tracked with HIV co-infection status and associations differed inversely by HBeAg status. The greater sensitivity and specificity of HBV RNA compared to HBcrAg allows for better discrimination of transcriptional activity regardless of HBeAg status.
【저자키워드】 HIV, HBV, serum biomarkers, HBcrAg, HBV RNA,