How common was chronic hepatitis B among people with HIV in this US cohort?

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The study aimed to examine hepatitis B virus (HBV) prevalence in people with HIV receiving contemporary antiretroviral therapy and in people without HIV, as well as risk factors among people with HIV/HBV coinfection. This retrospective cross-sectional study included 5,238 participants with HIV or at risk of acquiring HIV at 13 US sites in the MACS/WIHS Combined Cohort Study (Multicenter AIDS Cohort Study / Women Interagency HIV Study), between January 2018 and December 2024.

The primary outcome was the prevalence of HBV infection and HIV/HBV coinfection. A positive HBsAg (hepatitis B surface antigen) was defined as chronic HBV infection; negative HBsAg with positive anti-HBV core antibody as recovered infection; and negative results for both as never having been infected. The researchers described chronic and recovered HBV prevalence across different risk groups.

Overall, 2.4% of the cohort had chronic HBV, and 3.0% of people with HIV had HIV/HBV coinfection. Current and prior HBV infection were more common in men, and prior HBV prevalence increased with age. Compared with the other two groups, people with HIV and chronic HBV had lower CD4+ T-cell counts (567 vs 651 and 689 cells/µL), lower CD4+ T-cell nadirs (210 vs 245 and 258 cells/µL), and lower HIV viral suppression rates (71.7% vs 82.3% and 83.7%). Among people with HIV who had never had HBV, 40.6% lacked seroprotection against HBV.

The authors concluded that HBV remains prevalent among people with HIV. HBV coinfection was associated with lower CD4+ T-cell counts and HIV viral suppression rates. They said the low seroprotection rate among those without HBV highlights the need for better screening and immunization.