HEPATITIS-B IN PATIENTS WITH HIV-INFECTION - RELATIONSHIP TO AIDS AND PATIENT SURVIVAL

Hepatitis B virus (HBV) infection is common in patients infected with human immunodeficiency virus (HIV). Experimental evidence suggests that chronic HBV infection may accelerate the course of HIV-related disease, but clinical data are lacking. Therefore, we assessed the relationship of serologic markers for HBV infection to the presence of AIDS and length of survival in 511 patients with HIV infection, 233 (46%) of whom had AIDS. Hepatitis B virus markers were more prevalent in patients with AIDS (89%) than in those without AIDS (80%; P < 0.02). Among the various markers, anti-HBs did not differ between the groups (62% compared with 61%), whereas HBsAg, a marker of chronic infection, was more than twice as common in the AIDS group (10.7% compared with 4.7%; P < 0.02). Survival was shorter in patients with AIDS than in patients without AIDS but was not influenced in either group by the presence of HBsAg. These findings indicate that chronic HBV infection among HIV-infected patients is more prevalent in patients with AIDS than those without AIDS, and that this association probably reflects a manifestation of AIDS rather than an effect of HBV on progression of HIV-related disease.