HIV Therapy Protects Against Hepatitis Infection

Patients treated with HIV therapy less likely to get infected with HBV.

Prior studies have indicated that treatment of HIV with regimens that include drugs active against hepatitis B virus (HBV) can decrease the risk of infection with the liver-damaging HBV.

In a recent study involving 2,400 men who have sex with men, who were also enrolled in the Multicenter AIDS Cohort Study, researchers observed that men treated with HIV therapy were less likely to get infected with HBV over a median follow-up time of approximately 9.5 years.

Men with HIV who were not on therapy or men who had detectable HIV virus while on therapy did not have as favorable outcomes. Men on effective HIV therapy had the same risk profile of HBV infection as men who did not have HIV.

The findings are based on an analysis of men who have sex with men who were not infected with HBV at the time the cohort study began in 1984, 12 years prior to the availability of effective HIV therapy.

“What this means to us is that effective HIV therapy appears to restore an impairment in the immune response that protects someone with HIV from acquiring hepatitis B infection,” said senior author Chloe Thio, MD, professor of medicine at the Johns Hopkins University School of Medicine.

The study also confirmed researchers’ beliefs that vaccination against HBV protects individuals from acquiring a new HBV infection regardless of HIV infection status.

“We found a 70 percent reduction in new HBV infections in the men who reported receiving at least one dose of HBV vaccine,” said lead author Oluwaseun Falade-Nwulia, MD, MPH, an assistant professor of medicine at the Johns Hopkins University School of Medicine.

Unfortunately the vaccination rates, even among those at the highest risk of infection, such as men who have sex with men, remain low.

At the beginning of the 1984 study, 41 percent of men with HIV had been vaccinated against HBV, compared with 28 percent of men without HIV. By the end of the study period in 2013, the proportion of men who received more than one dose of HBV vaccine increased to 60 percent.

According to the U.S. Centers for Disease Control and Prevention, adults should get three doses within six months of the HBV vaccine.

While the findings underscore the benefits of therapy in those with HIV, it also indicates a strong need for increased HBV prevention in men who have sex with men in order to control the epidemic in this population. Between 15 and 25 percent of new HBV infections occur in men who have sex with men.

Researchers next plan to study next whether effective HIV therapy reduces the risk of developing a chronic hepatitis B infection and to learn which parts of the immune system are being restored by effective therapy to protect against HBV.