Z Gastroenterol 2018; 56(05): e47
DOI: 10.1055/s-0038-1654658
POSTER
Hepatologie
Georg Thieme Verlag KG Stuttgart · New York

Epidemiological trends of HBV and HDV coinfection among HIV+ patients

C Schmidbauer
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
D Chromy
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
V Schmidbauer
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
T Bucsics
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
P Schwabl
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
M Mandorfer
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
B Scheiner
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
A Rieger
3   Division of Immunodermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria
,
H Holzmann
4   Clinical Department of Virology, Medical University of Vienna, Vienna, Austria
,
M Trauner
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
,
T Reiberger
1   Vienna HIV & Liver Study Group, Vienna, Austria
2   Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
09 May 2018 (online)

Also available at
 

Background:

Despite vaccination recommendations for HIV+ individuals, hepatitis B (HBV) and D (HDV) coinfections are common in HIV-patients. Recent immigration trends and high-risk behaviour among MSMs might have changed the epidemiology of HBV/HDV coinfection among HIV+ in Europe. Thus, we retrospectively evaluated HBV/HDV epidemiology in HIV+ individuals in Vienna.

Patients & Methods:

N = 1874 HIV+ patients attending our clinic between 2014 – 2016 were assessed for HBV/HDV-serology at diagnosis (first visit) and at last contact at our clinic. We assessed immunization status as well as HBV (HBsAg+/HBV-DNA+) and HDV (anti-HDV+) coinfection rates at first and at last visit. Case numbers and frequency rates were analyzed using descriptive statistics.

Results:

N = 68 (3.6%) were never tested for HBV! At first visit n = 89/1793 (5.0%) patients showed HBsAg(+) and/or HBV-DNA-viremia. Another n = 417 (23.3%) showed virological HBV-clearance (HBsAg(-)/anti-HBc(+)/anti-HBs(+)). N = 1081 (60.3%) were HBV-negative (HBsAg(-)/anti-HBc(-)), however, only n = 377 (34.9%) had received vaccinations and showed anti-HBs(+). Among the n = 89 HBV/HIV-coinfected patients, only n = 51 (57.3%) were tested for HDV, of which n = 11 (21.6%) had anti-HDV(+) and n = 3/7 (42.9%) showed HDV-RNA-viremia.

Among the HBV-negative patients, n = 8/1081 (0.7%) acquired new HBV-infection (including n = 1/377 of initially vaccinated patients) – resulting in a total number of n = 59/1607 (3.7%) HBV/HIV-patients with n = 21 (35.6%) HBeAg(+) and n = 11 (18.6%) HBeAg(-) patients at last visit. N = 22/80 (27,5%) cleared their HBsAg(-) until their last visit, n = 136/704 (19.3%) received HBsAg-vaccinations. Among the total n = 97/1793 (5.4%) patients with HBV-coinfection, n = 56 (57.7%) underwent HBV-DNA PCR testing at last visit and n = 42 (75%) achieved HBV-DNA-suppression. HDV-testing was performed in n = 19/59 (32.2%) of HBV-patients at last visit, and HBV/HDV-coinfection was present in n = 6/19 (31.6%) of HBV/HIV-patients.

Conclusions:

While HBV-testing is regularly performed among HIV+ patients, HBV-vaccinations were not sufficiently implemented with only 45.4% of eligible HIV+ patients showing protective anti-HBs titers. HDV-testing is not systematically performed, while up to one third of HBV/HIV-patients may have HDV-co/superinfection.