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

Author:

Malagnino Vincenzo1ORCID,Cerva Carlotta1,Cingolani Antonella2,Ceccherini-Silberstein Francesca1,Vergori Alessandra3,Cuomo Gianluca4,Perno Carlo Federico5,Puoti Massimo6,d’Arminio Monforte Antonella7,Cozzi-Lepri Alessandro8,Andreoni Massimo1,Sarmati Loredana1ORCID,d’Arminio Monforte A,Antinori A,Andreoni M,Castagna A,Castelli F,Cauda R,Di Perri G,Galli M,Iardino R,Ippolito G,Lazzarin A,Marchetti G C,Rezza G,von Schloesser F,Viale P,d’Arminio Monforte A,Antinori A,Castagna A,Ceccherini-Silberstein F,Cozzi-Lepri A,Girardi E,Gori A,Lo Caputo S,Maggiolo F,Mussini C,Puoti M,Perno C F,Antinori A,Bai F,Bandera A,Bonora S,Borderi M,Calcagno A,Capobianchi M R,Castagna A,Ceccherini-Silberstein F,Cicalini S,Cingolani A,Cinque P,Cozzi-Lepri A,d’Arminio Monforte A,Di Biagio A,Gagliardini R,Girardi E,Gianotti N,Gori A,Guaraldi G,Lapadula G,Lichtner M,Lai A,Lo Caputo S,Madeddu G,Maggiolo F,Marchetti G,Merlini E,Mussini C,Nozza S,Perno C F,Piconi S,Pinnetti C,Puoti M,Quiros Roldan E,Rossotti R,Rusconi S,Santoro M M,Saracino A,Sarmati L,Spagnuolo V,Svicher V,Taramasso L,Cozzi-Lepri A,Fanti I,Galli L,Lorenzini P,Rodanó A,Macchia M,Tavelli A,Bove A,Camposeragna A,Errico M,Manfredini M,Perziano A,Calvino V,Carletti F,Carrara S,Di Caro A,Graziano S,Petroni F,Prota G,Truffa S,Giacometti A,Costantini A,Barocci V,Angarano G,Monno L,Milano E,Maggiolo F,Suardi C,Viale P,Donati V,Verucchi G,Castelnuovo F,Minardi C,Quiros Roldan E,Menzaghi B,Abeli C,Chessa L,Pes F,Cacopardo B,Celesia B,Vecchiet J,Falasca K,Pan A,Lorenzotti S,Sighinolfi L,Segala D,Blanc P,Vichi F,Cassola G,Bassetti M,Alessandrini A,Bobbio N,Mazzarello G,Lichtner M,Fondaco L,Bonfanti P,Molteni C,Chiodera A,Milini P,Nunnari G,Pellicanò G,d’Arminio Monforte A,Galli M,Lazzarin A,Rizzardini G,Puoti M,Castagna A,Cannizzo E S,Moioli M C,Piolini R,Bernacchia D,Poli A,Tincati C,Mussini C,Puzzolante C,Migliorino C,Lapadula G,Sangiovanni V,Borgia G,Esposito V,Di Flumeri G,Gentile I,Rizzo V,Cattelan A M,Marinello S,Cascio A,Trizzino M,Francisci D,Schiaroli E,Parruti G,Sozio F,Lazzaretti C,Corsini R,Andreoni M,Antinori A,Cauda R,Cristaudo A,Vullo V,Acinapura R,Lamonica S,Capozzi M,Mondi A,Cingolani A,Rivano Capparuccia M,Iaiani G,Latini A,Onnelli G,Plazzi M M,De Girolamo G,Vergori A,Cecchetto M,Viviani F,Madeddu G,De Vito A,Rossetti B,Montagnani F,Franco A,Fontana Del Vecchio R,Di Giuli C,Caramello P,Di Perri G,Bonora S,Orofino G C,Sciandra M,Londero A,Manfrin V,Battagin G,Starnini G,Ialungo A,

Affiliation:

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

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.

Funder

Gilead Sciences

ViiV Healthcare

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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