Compartmental shedding of HIV and HBV in coinfected patients

Frank Duy Duc Trinh, San Mateo County San Francisco Peninsula AIDS Research Center

Human immunodeficiency virus (HIV)-1 and hepatitis B virus (HBV) infections are major global public health problems. Due to shared routes of transmission, a large percentage of patients infected with HIV also have HBV infection. The study of HIV and HBV coinfection is important as HBV infection in HIV-positive people often produces significant liver disease. The impact of HBV coinfection on blood and genital fluid virus levels in HIV-positive individuals is unclear.

We are enrolling a group of participants with both HIV and HBV infection to be followed over a 1 year period. HIV and HBV virus levels in the blood and genital fluid of these individuals will be evaluated by polymerase chain reaction (PCR) to see how they relate to each other. The presence of drug-resistant HBV in these participants will also be determined by DNA sequencing to gain insight into whether resistant HBV can be spread to others. We hypothesize that 1) the interaction between HIV and HBV virus levels will be different depending on the type of treatment being received by the patient, and 2) individuals with drug-resistant HBV will have the potential to transmit drug-resistant virus to others.

The results of this study will be important in developing strategies to prevent liver disease and liver-related death in people infected with both HIV and HBV in California. Understanding the effect of various treatment regimens on viral levels will help in the optimization of HIV and HBV therapy. Furthermore, determining whether drug-resistant HBV can be spread to others will have important implications on transmission prevention and management of HBV infection in HIV-positive patients.