Clinical, Epidemiological and Diagnostic Aspects of Combined HIV-CHB Infection

Objective is to characterize the epidemiological and clinical-diagnostic features of chronic hepatitis B (CHB) in the context of HIV coinfection in real-world clinical practice.

Materials and methods. A single-center cross-sectional study was conducted at the Republican Center for AIDS and Infectious Diseases Prevention and Control in Kazan. Medical records of 117 patients with HIV infection and HBV markers who were under observation from 2021 to 2023 were analyzed. Laboratory findings and data from epidemiological investigation forms were reviewed. Categorical variables are presented as absolute values and percentages.

Results and discussion. HBsAg was detected in 95 (81.20 %) patients, while 22 (18.80 %) had only anti-HBc, indicating loss of HBsAg. The majority were male (89 (76.07 %)), with an age of 45 [42; 48] years. Patients aged 40– 49 years accounted for 85/117 (72.65 %). At the time of HIV diagnosis, most patients were at stage IVА (65.72 %) or IVB (23.93 %). The median duration of clinical follow-up was 15 [10; 22] years, and median antiretroviral therapy (ART) duration was 8 [5; 12] years (one patient had not received ART). Injection drug use was the main transmission route (68 (58.12 %)). Anti-HCV antibodies were detected in 85 (72.65 %) patients, and HDV markers were found in 7 (5.98 %) cases.

Conclusion. The findings highlight the need for long-term monitoring of HIV-СHB coinfected patients. Comprehensive diagnostic approaches and individualized ART regimens are recommended to reduce the risk of HBV reactivation and disease progression.

1. Esaulenko EV, Sukhoruk AA, Ponyatishina MV, Shibaeva EO, Zakharov KA. Clinical and laboratory characteristics of occult hepatitis B. Journal of Infectology. 2016;8(1):66–72. (In Russ.). EDN: https://elibrary.ru/VTNSLH.

2. Ostankova YuO, Semenov AV, Zueva EB, Totolian AA. The prevalence of occult hepatitis b among HBsAg-negative persons with HIV in Veliky Novgorod. HIV Infection and Immunosuppressive Disorders. 2019;11(1):64–70. (In Russ.). DOI: https://doi.org/10.22328/2077-9828-2019-11-1-64-70.

3. Ji DZ, Pang XY, Shen DT, Liu SN, Goyal H, Xu HG. Global prevalence of occult hepatitis B: A systematic review and meta-analysis. Journal of Viral Hepatitis. 2022;29(5):317–329. DOI: https://doi.org/10.1111/jvh.13660.

4. Tereshkov DV, Miczura VM, Voropaev EV, Osipkina OV. Viral coinfections in patients with chronic hepatitis B: Their prevalence and clinical significance. Hepatology and Gastroenterology. 2020;4(2):171–176. (In Russ.). DOI: https://doi.org/10.25298/2616-5546-2020-4-2-171-176.

5. Semenov AV, Ostankova YuV, Serikova EN, Zueva EB, Totolian AA. Optimization of the algorithm diagnosis chronic hepatitis B markers in patients with newly diagnosed HIV infection. Klinicheskaya Laboratornaya Diagnostika (Russian Clinical Laboratory Diagnostics). 2020;65(9):574–579. (In Russ.). DOI: https://doi.org/10.18821/0869-2084-2020-65-9-574-579.

6. Ostankova YuV, Semenov AV, Zueva EB, Serikova EN, Shchemelev AN, Valutite DE, et al. Prevalence of hepatitis B and D viruses in HIV-infected individuals in the Socialist Republic of Vietnam. HIV Infection and Immunosuppressive Disorders. 2022;14(1):46–58. (In Russ.). DOI: https://doi.org/10.22328/2077-9828-2022-14–1-46-58.

7. Bazykina EA, Turkutyukov VB, Trotsenko OE, Kotova VO, Balakhontseva LA, Butakova LV, et al. Prevalence and molecular genetic characteristics of the hepatitis B virus in HIV-positive individuals in the Far Eastern Federal District. Russian Journal of Infection and Immunity. 2019;9(1):183–192. (In Russ.). DOI: https://doi.org/10.15789/2220-7619-2019-1-183-192.

8. Babazarov IZ. Epidemiologic profile of hepatitis B virus infection among people living with HIV and AIDS. Infectious Diseases: News, Opinions, Training. 2023;12(2):65–68. DOI: https://doi.org/10.33029/2305-3496-2023-12-2-65-68.

9. Vlasik RA, Ostankova YuV, Semenov AV. Immunological aspects of HIV-infected individuals coinfected with hepatitis B virus. Medical Immunology. 2017;19(Suppl):214. (In Russ.). EDN: https://elibrary.ru/ZBFEVD.

10. Tereshkov DV, Mitsura VM. Chronic hepatitis B viral infection: Clinical characteristics and antiviral therapy. Health and Ecology Issues. 2022;19(2):82–89. (In Russ.). DOI: https://doi.org/10.51523/2708-6011.2022-19-2-10.

11. Kobyakov OS, Deev IA, Lukashova LV, Kulikov ES, Plotnikova YK, Skudarnov SE, et al. Epidemiology of HIV infection: The reality of clinical practice. HIV Infection and Immunosuppressive Disorders. 2020; 12(1):113–122. (In Russ.). DOI: https://doi.org/10.22328/2077-9828-2020-12-1-113-122.

12. Danilov DE. Results of antiviral treatment discontinuation in patients with chronic hepatitis B virus infection. Clinical Infectology and Parasitology. 2021;10(2):200–207. (In Russ.). DOI: https://doi.org/10.34883/PI.2021.10.2.026.

13. Nguyen TH, Melnikova LI, Ilchenko LYu, Kyuregyan KK, Gordeychuk IV, Bondarenko NL. Clinical and virological characteristics of chronic hepatitis B and response to antiviral therapy. Extreme Medicine. 2023; 25(1):59–67. (In Russ., Eng.). DOI: https://doi.org/10.47183/mes.2023.003.

14. Soriano V, de Mendoza C, Peña JM, Barreiro P. Advances in treating drug-resistant hepatitis B virus in HIV-infected patients. Expert Opinion on Pharmacotherapy. 2015;16(2):179–186. DOI: https://doi.org/10.1517/14656566.2015.973852.

15. Yushchuk ND, Klimova EA, Znoyko OO, Karetkina GN, Maksimov SL, Maev IV. Viral hepatitis: clinic, diagnostics, treatment. 4th ed., rev. and enl. Moscow: GEOTAR-Media; 2023. 280 p. (In Russ.). DOI: https://doi.org/10.33029/9704-7640-6-VGK-2023-1-280.

16. Pokrovskii VV, Yurin OG, Kravchenko AV, Belyaeva VV, Ermak TN, Kanestri VG, et al. Recommendations for the treatment of HIV infection and associated diseases, chemoprophylaxis of HIV infection. Epidemiology and Infectious Diseases. Current Issues. 2018;(4 Suppl):5–84. (In Russ.). EDN: https://elibrary.ru/VXKDRU.

17. Mamedov MK, Mikhailov MI. Main results of studies on oncological aspects of hepatitis B virus over the past thirty years. Hepatology and Gastroenterology. 2024;8(1):11–17. (In Russ.). DOI: https://doi.org/10.25298/2616-5546-2024-8-1-11-17.

18. Shchemelev AN, Ostankova YuV, Zueva EB, Boumbaly S, Balde ThAL, Semenov AV. Characterization of hepatitis B virus and human immunodeficiency virus among HIV/HBV co-infected patients from the Republic of Guinea. Problems of Particularly Dangerous Infections. 2019;(3):118–124. (In Russ.). DOI: https://doi.org/10.21055/0370-1069-2019-3-118-124.

19. Semenov AV, Ostankova YuV. Occult (latent) hepatitis B virus: Problems of laboratory diagnostics. Infectious Diseases: News, Opinions, Training. 2019;8(3):60–69. (In Russ.). DOI: https://doi.org/10.24411/2305-3496-2019-13010.

20. Aftaeva LN, Melnikov VL, Nikolskaya MV, Bilyk AG. Prospects for the use of long-term antiviral therapy for chronic hepatitis B. Bulletin of the Penza State University. 2020;(1):62–67. (In Russ.). EDN: https://elibrary.ru/SYYUBH.

21. Omarova HG, Makashova VV, Ponezheva ZhB. The features of the course of HBV infection during antiviral therapy. Epidemiology and Infectious Diseases. Current Issues. 2022;12(1):60–63. (In Russ.). DOI: https://doi.org/10.18565/epidem.2022.12.1.60-3.

22. Boumbaly S, Serikova EN, Balde ThAL, Ostankova YuV, Shchemelev AN, Valutite DE, et al. Amino acid substitutions in core and HBsAg regions of hepatitis B virus in patients with monoinfection and HBV/HIV-coinfection in the Republic of Guinea. HIV Infection and Immunosuppressive Disorders. 2021;13(3):96–107. DOI: https://doi.org/10.22328/2077-9828-2021-13-3-96-107.

23. Pozdeeva ES. Risk factors for the formation of combined forms of HIV infection and parenteral viral hepatitis. Problems of Medical Mycology. 2020;22(3):117. (In Russ.). EDN: https://elibrary.ru/SYACYT.

24. Rassokhin VV, Boeva EV. Issues of epidemiology and pathogenesis of HIV-HCV co-infection. HIV Infection and Immunosuppressive Disorders. 2020;12(1):32–46. (In Russ.). DOI: https://doi.org/10.22328/2077-9828-2020-12-1-32-46.

25. Kartashov MYu, Svirin KA, Krivosheina EI, Chub EV, Ternovoy VA, Kochneva GV. Prevalence and molecular genetic characteristics of parenteral hepatitis B, C and D viruses in HIV-positive individuals in the Novosibirsk region. Problems of Virology. 2022;67(5):423–438. (In Russ.). DOI: https://doi.org/10.36233/0507-4088-133.