HAART Linked with Lower HBV Rate in Men Who Have Sex With Men
Effective HAART may protect against incident HBV, however prevalence remains high.
HealthDay News -- For men who have sex with men (MSM), highly active antiretroviral therapy (HAART) is associated with lower incidence of hepatitis B virus (HBV), according to a study published online in the Annals of Internal Medicine.
Oluwaseun Falade-Nwulia, MD, MPH, from Johns Hopkins University in Baltimore, and colleagues examined the impact of HAART on incident HBV in HIV-infected and HIV-uninfected MSM. Predictors of incident HBV were examined in a prospective observational cohort study involving 2,375 MSM uninfected with HBV at enrollment.
The researchers identified 244 incident HBV infections during 25,322 person-years of follow-up. HIV-infected versus HIV-uninfected men had a higher unadjusted incidence rate (incidence rate ratio [IRR], 1.9). Among HIV-infected and HIV-uninfected MSM, the unadjusted incidence rate was significantly lower in the HAART (1996 to 2013) versus the pre-HAART (before 1996) era (IRR, 0.2 and 0.3, respectively).
Risk factors for incident HBV included age younger than 40 years (IRR, 2.3), more than one sexual partner in the previous six months (IRR, 3.1), and HIV infection (IRR, 2.4) in multivariate analysis; one or more doses of HBV vaccine were found to be protective (IRR, 0.3). HAART with an HIV RNA <400 copies/ml was protective (IRR, 0.2) in HIV-infected MSM, while HAART with an HIV RNA ≥400 copies/ml was not.
"Effective HAART protects against incident HBV; however, even in the HAART era, incident HBV in MSM remains high," the authors write.
1. Falade-Nwulia O, Seaberg EC, Snider AE, et al. Incident Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Men Who Have Sex With Men From Pre-HAART to HAART Periods: A Cohort Study. Ann Intern Med. Published online 13 October 2015 doi:10.7326/M15-0547