A new study from Johns Hopkins Medicine found that HIV drugs may have the added benefit of also protecting against hepatitis B infection. However, researchers still urge at-risk patients to get vaccinated.
"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 study author Chloe Thio, MD, a professor of medicine at the Johns Hopkins University School of Medicine, in a press release.
Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). It is transmitted via blood, semen, or other bodily fluids and can occur through sexual contact, sharing needles or at birth.
For some patients, hepatitis B is a short-term illness. But for others, it can become chronic. Chronic hepatitis B can lead to serious health issues like cirrhosis (liver damage) or liver cancer. According to the Centers for Disease Control and Prevention (CDC), the best way to prevent HBV infection is through vaccination.
HIV (human immunodeficiency virus) is an infection that affects specific cells of the immune system called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease.
If left untreated, HIV can lead to AIDS (acquired immune deficiency syndrome). AIDS is the final stage of HIV infection, and not all HIV patients advance to this stage. Without treatment, patients who are diagnosed with AIDS typically survive about three years.
For this study, Dr. Thio and team looked at 2,400 men who were enrolled in the Multicenter AIDS Cohort Study — a study that began in 1984 (12 years before effective HIV therapy became available). All of these men reported having sex with other men. None were infected with HBV at the study's start.
At the study's start in 1984, 41 percent of men with HIV had been vaccinated against HBV — compared to 28 percent of men without HIV.
The men who were treated effectively with HIV therapy (defined as no detectable HIV virus in the blood) had an 80 percent lower risk of HBV infection over an average follow-up period of 9.5 years than men who were not on HIV therapy or men whose HIV therapy was not effective.
In fact, the men on effective HIV therapy had the same risk of HBV infection as men who did not have HIV.
While these findings highlight the added benefits of effective HIV therapy, Dr. Thio and colleagues noted that HBV vaccination remains crucial to controlling the epidemic in at-risk populations. According to the CDC, 15 to 25 percent of new HBV infections in the US occur in men who have sex with men.
Because both HBV and HIV can be transmitted through sexual contact, dual infection is common. This can be especially serious because liver disease can progress more rapidly in HIV patients.
"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 study author Oluwaseun Falade-Nwulia, MD, MPH, an assistant professor of medicine at Johns Hopkins, in a press release. "Sadly, vaccination rates, even in high-risk individuals, such as men who have sex with men, remain low, and we need to do a better job of encouraging vaccination."
This study was published Oct. 12 in the journal Annals of Internal Medicine.
The National Institute of Allergy and Infectious Diseases and the National Cancer Institute funded this research. No conflicts of interest were disclosed.