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来自意大利HIV感染患者ICONA队列的HIV/HCV阳性受试者中，乙肝核心抗体阳性会增加发生严重肝纤维化的风险。

HBcAb Positivity Increases the Risk of Severe Hepatic Fibrosis Development in HIV/HCV-Positive Subjects From the ICONA Italian Cohort of HIV-Infected Patients.

作者信息

Malagnino Vincenzo, Cerva Carlotta, Cingolani Antonella, Ceccherini-Silberstein Francesca, Vergori Alessandra, Cuomo Gianluca, Perno Carlo Federico, Puoti Massimo, d'Arminio Monforte Antonella, Cozzi-Lepri Alessandro, Andreoni Massimo, Sarmati Loredana

机构信息

University of Rome Tor Vergata, Rome, Italy.

Catholic University of the Sacred Heart, Rome, Italy.

出版信息

Open Forum Infect Dis. 2020 Nov 18;8(1):ofaa566. doi: 10.1093/ofid/ofaa566. eCollection 2021 Jan.

DOI:10.1093/ofid/ofaa566
PMID:33447635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7781466/
Abstract

BACKGROUND

The aim of this study was to investigate the impact of anti-HBc (HBcAb) positivity on the progression of liver fibrosis (Fibrosis-4 score >3.25) in the Italian cohort of HIV-infected individuals naïve to antiretroviral treatment (ICONA).

METHODS

All patients with FIB-4 <3.25 at baseline were evaluated prospectively: 6966 people with HIV (PWH) were screened and classified based on hepatitis B virus (HBV) and hepatitis C virus (HCV) serology.

RESULTS

Patients who were HBcAb+/HCV-/HBs antigen (HBsAg)- and HCV+/HBcAb+/HBsAg- or HBsAg+/HBcAb+/HCV- had CD4+ cell counts below the nadir and significantly higher prevalence of AIDS diagnosis at baseline than the other groups ( < .0001). A Cox regression model adjusted for age, HIV transmission mode, country of birth, and alcohol consumption showed a higher relative risk (HR) of progression to FIB-4 >3.25 in HCV+/HBcAb+/HBsAg- patients (HR, 7.2; 95% CI, 3 8-13.64).

CONCLUSIONS

HBcAb+ contributes to liver damage in HIV+/HCV+/HBcAb+/HBsAg- subjects. A careful monitoring for signs of previous HBV infection is needed in this kind of patients.

摘要

背景

本研究旨在调查在意大利未接受抗逆转录病毒治疗的HIV感染者队列（ICONA）中，抗-HBc（HBcAb）阳性对肝纤维化进展（Fibrosis-4评分>3.25）的影响。

方法

对所有基线时FIB-4<3.25的患者进行前瞻性评估：对6966名HIV感染者（PWH）进行筛查，并根据乙肝病毒（HBV）和丙肝病毒（HCV）血清学进行分类。

结果

HBcAb+/HCV-/乙肝表面抗原（HBsAg）-以及HCV+/HBcAb+/HBsAg-或HBsAg+/HBcAb+/HCV-的患者，其CD4+细胞计数低于最低点，且基线时艾滋病诊断患病率显著高于其他组（P<.0001）。经年龄、HIV传播方式、出生国家和饮酒量调整的Cox回归模型显示，HCV+/HBcAb+/HBsAg-患者进展为FIB-4>3.25的相对风险（HR）更高（HR，7.2；95%CI，3.8-13.64）。

结论

HBcAb+会导致HIV+/HCV+/HBcAb+/HBsAg-患者出现肝损伤。对此类患者需要密切监测既往HBV感染的迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3939/7781466/920ed9446280/ofaa566_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3939/7781466/920ed9446280/ofaa566_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3939/7781466/920ed9446280/ofaa566_fig1.jpg

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