DOES HEPATITIS B VIRAL INFECTION PROMOTE HIV-1 INFECTION AND THE PROGRESSION TO AIDS?
Resource
DOCTOR OF PHILOSOPHY IN EPIDEMIOLOGY (UCLA)
Journal
DOCTOR OF PHILOSOPHY IN EPIDEMIOLOGY
Journal Issue
ucla
Pages
-
Date Issued
1991
Date
1991
Author(s)
TWU, SHIING-JER
Abstract
Human immunodeficiency virus (HIV-1) has been documented to be a causative factor for acquired immunodeficiency syndrome (AIDS). However, other factors may be involved in promoting HIV-1 infection and AIDS. The Multicenter AIDS Cohort Study (MACS) was designed to study the natural history and cofactors of HIV-1 infection and progression, including the relationship between HBV and HIV-1. MACS is a prospective cohort study of volunteer homosexual men. A total of 4,955 homosexual/bisexual men were recruited from April 1984 through March 1985 and have been followed-up thereafter every six months. Hepatitis B surface antigen ( HBsAg) and hepatitis core antibody (HBcAb) were tested for at the first visit with RIA or EIA. HIV-1 antibody status was determined at each visit by ELISA and confirmed by Western Blot assay. The role of HBV infection in HIV-1 seroconversion and progression was studied by stratification for sexual behavior visit by visit, by logistic regression, and by Cox's proportional hazard regression model. The incidence of HIV-1 seroconversion decreased from 3.19 per 100 person-half-year between visits one and two to 0.33 per 100 person-half-year between visits eight and nine. After controlling for sexual behavior visit-by-visit, the adjusted risk ratio for HIV-1 seroconversion was 2.02 for HBsAg carriers (HBGr1) as compared to hepatitis B susceptible men (HBGr4) and 2.14 for hepatitis immune cases(HBGr2) as compared to hepatitis B susceptible men. The same results were obtained by applying the logistic regression model. The adjusted risk ratio for AIDS incidence after controlling for sex behavior eighteen to thirty months prior to a visit was 0.92 for HBGr1 versus HBGr4 and 0.74 for HBGr2 versus HBGr4. Using Cox's proportional hazard regression model, prior HB infection was not found to be related to the progression of HIV-1 disease to AIDS or the changs of slopes of CD4(+) T cell percentage. We conclude that past hepatitis B infection may a cofactor for HIV-1 seroconversion but not necessarily a cofactor for HIV-1 progression.#B0191001
SDGs
Type
thesis