High Prevalence of Hepatitis B in People with HIV in the MWCCS, 2018-2024

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ID: 316078
2026
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Abstract
Abstract Objective To examine the prevalence of hepatitis B virus (HBV) in people with HIV (PWH) on contemporary antiretroviral therapy (ART) and people without HIV (PWoH) and understand the risk factors in people with HIV/HBV co-infection. Design Retrospective cross-sectional study including 5,238 participants with HIV or at risk for HIV acquisition across 13 U.S. MACS/WIHS Combined Cohort Study (MWCCS) sites between 01/2018 and 12/2024. Methods The primary outcome is the prevalence of HBV infection and HIV/HBV co-infection. We defined a positive HBsAg (surface antigen) as chronic HBV infection; negative HBsAg and positive anti-HBV core antibody (anti-HBc) as recovered infection; and both negative HBsAg and anti-HBc as never infection. Prevalence of chronic and recovered HBV infection was described in different risk groups. Results In this cohort, the overall prevalence of chronic HBV was 2.4% and HIV/HBV co-infection was 3.0% among PWH. Both current and prior HBV infection was more common in men, and the prevalence of prior HBV increased with age. In PWH, lower CD4+ T-cell counts (567 vs. 651 and 689 cells/µL), CD4+ T-cell nadirs (210 vs. 245 and 258 cells/µL), and HIV viral suppression rate (71.7% vs. 82.3% and 83.7%) were seen in individuals with chronic HBV infection compared with the other two groups. Among PWH who never had HBV infection, 40.6% lacked seroprotection against HBV. Conclusions HBV is still prevalent in PWH. HBV co-infection was associated with lower CD4+ T-cell counts and viral suppression rate in PWH. Low seroprotection rate in those without HBV underscores the need for improved screening and immunization.
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Authors Maria Sanes Guevara, Ken S. Ho, Anandi N. Sheth, Andrew Edmonds, Audrey L. French, David B Hanna, Heather King, Jennifer C Price, Maria L Alcaide, M Mimiaga, Michael Augenbraun, MW Plankey, Stephen Gange, V Stosor, Bernard J C Macatangay, Eric C. Seaberg, Phyllis C. Tien, Chloe L Thio, Y LI, Cecile Lahiri, Anandi Sheth, Gina Wingood, Todd Brown, Joseph Margolick, Kathryn Anastos, David Hanna, Anjali Sharma, Deborah R Gustafson, Tracey Wilson, Gypsyamber DʼSouza, Elizabeth Topper, Mardge Cohen, Audrey French, Ryan Ross, Steven Wolinsky, Frank Palella, Bradley Aouizerat, Jennifer Price, Phyllis Tien, Roger Detels, Matthew Mimiaga, S. Kassaye, Daniel Merenstein, Maria Alcaide, Margaret Fischl, Deborah L Jones, Jeremy Martinson, Charles Rinaldo, Mirjam‐Colette Kempf, James B. Brock, Emily Levitan, M Bradley Drummond, Michelle Floris-Moore
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Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag346
URL
https://doi.org/10.1093/ofid/ofag346
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