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

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

doi:10.1093/ofid/ofaa566

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

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

Collaborators

ICONA Foundation Study Group:
A d'Arminio Monforte, A Antinori, M Andreoni, A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G C Marchetti, G Rezza, F von Schloesser, P Viale, A d'Arminio Monforte, A Antinori, A Castagna, F Ceccherini-Silberstein, A Cozzi-Lepri, E Girardi, A Gori, S Lo Caputo, F Maggiolo, C Mussini, M Puoti, C F Perno, A Antinori, F Bai, A Bandera, S Bonora, M Borderi, A Calcagno, M R Capobianchi, A Castagna, F Ceccherini-Silberstein, S Cicalini, A Cingolani, P Cinque, A Cozzi-Lepri, A d'Arminio Monforte, A Di Biagio, R Gagliardini, E Girardi, N Gianotti, A Gori, G Guaraldi, G Lapadula, M Lichtner, A Lai, S Lo Caputo, G Madeddu, F Maggiolo, G Marchetti, E Merlini, C Mussini, S Nozza, C F Perno, S Piconi, C Pinnetti, M Puoti, E Quiros Roldan, R Rossotti, S Rusconi, M M Santoro, A Saracino, L Sarmati, V Spagnuolo, V Svicher, L Taramasso, A Cozzi-Lepri, I Fanti, L Galli, P Lorenzini, A Rodanó, M Macchia, A Tavelli, A Bove, A Camposeragna, M Errico, M Manfredini, A Perziano, V Calvino, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, L Monno, E Milano, F Maggiolo, C Suardi, P Viale, V Donati, G Verucchi, F Castelnuovo, C Minardi, E Quiros Roldan, B Menzaghi, C Abeli, L Chessa, F Pes, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, F Vichi, G Cassola, M Bassetti, A Alessandrini, N Bobbio, G Mazzarello, M Lichtner, L Fondaco, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, A d'Arminio Monforte, M Galli, A Lazzarin, G Rizzardini, M Puoti, A Castagna, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, A Poli, C Tincati, C Mussini, C Puzzolante, C Migliorino, G Lapadula, V Sangiovanni, G Borgia, V Esposito, G Di Flumeri, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, D Francisci, E Schiaroli, G Parruti, F Sozio, C Lazzaretti, R Corsini, M Andreoni, A Antinori, R Cauda, A Cristaudo, V Vullo, R Acinapura, S Lamonica, M Capozzi, A Mondi, A Cingolani, M Rivano Capparuccia, G Iaiani, A Latini, G Onnelli, M M Plazzi, G De Girolamo, A Vergori, M Cecchetto, F Viviani, G Madeddu, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, C Di Giuli, P Caramello, G Di Perri, S Bonora, G C Orofino, M Sciandra, A Londero, V Manfrin, G Battagin, G Starnini, A Ialungo

Affiliations

¹ University of Rome Tor Vergata, Rome, Italy.
² Catholic University of the Sacred Heart, Rome, Italy.
³ IRCCS Lazzaro Spallanzani, Rome, Italy.
⁴ University of Modena and Reggio Emilia, Modena, Italy.
⁵ Pediatric Hospital Bambino Gesù, Rome, Italy.
⁶ ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
⁷ ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy.
⁸ University College London, London, UK.

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 (P < .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.

Keywords: HBV; HIV/HBV coinfection; OBI; anti-HBc; liver fibrosis.