Hepatitis B virus reactivation or reinfection associated with HIV-1 infection

AIDS. 1988 Dec;2(6):443-8. doi: 10.1097/00002030-198812000-00006.

Abstract

Following acute hepatitis B virus (HBV) infection, most individuals develop antibodies to HBV surface (anti-HBs) and core antigen (anti-HBc). Prevalence studies have shown that 10-18% develop anti-HBc in the absence of detectable anti-HBs. We report four such cases, all with persistence of serum anti-HBc, who had evidence of a second period of active HBV replication as demonstrated by the reappearance of serum hepatitis B surface antigen (HBsAg). In one patient, an HBsAg subtype difference indicated that the second period of HBsAg-positivity was due to a reinfection. In the other cases, reactivation may also explain the findings. All cases were anti-HIV-1 seropositive at the time of reappearance of HBsAg. There is experimental evidence that anti-HBc has a protective effect against HBV infection; however, this may require intact cell-mediated immunity to be effective. HIV-1 infection may render such patients susceptible to reinfection. Alternatively, some patients with anti-HBc, but without detectable anti-HBs may have latent HBV infection. Immunosuppression associated with HIV-1 infection may allow reactivation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Adult
  • HIV-1*
  • Hepatitis B / complications*
  • Hepatitis B / immunology
  • Hepatitis B / microbiology
  • Hepatitis B Antibodies / isolation & purification
  • Hepatitis B Surface Antigens / isolation & purification
  • Hepatitis B virus / physiology
  • Humans
  • Male
  • Virus Replication

Substances

  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens