Detectable Hepatitis B Virus (HBV) PreS Deletion Mutants at Baseline Predicted Delayed Immune Reconstitution and Increased Inflammation in People With Human Immunodeficiency Virus and HBV Coinfection Undergoing Long-term Antiretroviral Therapy.

Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection is common due to similar routes of transmission. Even though antiretroviral therapy (ART) regimens containing tenofovir suppressed HIV and HBV effectively, slower CD4 T-cell recovery was still reported in people with HIV/HBV coinfection. Here, a large and longitudinal treated HIV/AIDS cohort including HBV-coinfected individuals was enrolled, and people with HIV/HBV coinfection were categorized into groups with or without deletion mutants based on the PreS sequence of HBV in plasma at treatment baseline. Subsequent to >4 years of ART, longitudinal CD4 T-cell counts and CD4/CD8 ratios were consistently lower and inflammatory cytokines such as IL-10, IL-18, IP-10, MCP-1, and IFN-γ were significantly higher in the group with PreS deletion mutants compared to the group without PreS deletion mutants; in addition, either HIV or HBV in plasma was consistently undetectable during ART. HBV PreS deletion mutants in blood at baseline could be an important predictor for delayed immune reconstitution in people with HIV/HBV coinfection, related to enhanced inflammatory response.