{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T17:35:16Z","timestamp":1793208916920,"version":"4.5.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Am J Gastroenterol"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Because most HBV\/HIV co-infected patients on combination antiretroviral therapy (cART) have suppressed HBV DNA and normal liver enzymes, the histologic spectrum of liver disease in HBV\/HIV coinfection is poorly defined. To address this gap in knowledge, we conducted a prospective study to comprehensively characterize liver disease severity assessed by liver biopsy in a well-defined cohort of HBV\/HIV patients in North America receiving cART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Adult HIV\/HBsAg positive patients on stable cART were recruited. Demographic, clinical, serological, and virological data were collected. Liver histology was assessed by a central pathology committee. The association of demographic, clinical, serologic, and virologic characteristics with liver histology was assessed using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional analysis, the mean age of the cohort (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 139) was 49 years; 92% were male, 51% were non-Hispanic black, 7% had at-risk alcohol use with a median duration of infections of 14 years. The median ALT was 28 IU\/L and CD4 count was 568 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      . Almost all (99%) were on cART. Three-fourths (75%) had undetectable HIV RNA (&lt;20 copies\/mL). HBeAg was positive in 62%, HBV DNA was below the limit of quantification (&lt;20 IU\/mL) in 57% and &lt;1000 IU\/ mL in 80%; 7% had incomplete viral suppression (HBV DNA \u22651000 IU\/mL and HIV RNA &lt;20 copies\/mL). Liver histology (available in\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 114) showed significant periportal, lobular, and portal inflammation (scores \u22652) in 14%, 31%, and 22% respectively. Over a third (37%) had significant fibrosis (Ishak stage \u22652); 24% had advanced fibrosis (Ishak stage \u22653). Higher ALT (adjusted OR 1.19 per 10 IU\/L; 95% CI [1.01, 1.41];\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.03) and lower platelet count (adjusted OR 0.81 per 20,000 mm\n                      <jats:sup>3<\/jats:sup>\n                      ; 95% CI [0.67\u20130.97];\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02) but not HBV DNA were independently associated with advanced fibrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In this cohort of patients with HBV\/HIV coinfection receiving long-term cART with viral suppression, we observed significant fibrosis in more than one-third of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41395-018-0409-9","type":"journal-article","created":{"date-parts":[[2018,11,8]],"date-time":"2018-11-08T05:58:46Z","timestamp":1541656726000},"page":"746-757","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Spectrum of Liver Disease in Hepatitis B Virus (HBV) Patients Co-infected with Human Immunodeficiency Virus (HIV): Results of the HBV-HIV Cohort Study"],"prefix":"10.14309","volume":"114","author":[{"given":"Richard K.","family":"Sterling","sequence":"first","affiliation":[{"name":"Virginia Commonwealth University, Richmond, VA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdus S.","family":"Wahed","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy 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K.","family":"Jain","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern, Dallas, TX, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Lisker-Melman","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine, St. Louis, MO, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Wong","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G.","family":"Ghany","sequence":"additional","affiliation":[{"name":"National Institutes of Health, Bethesda, MD, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the HIV-HBV Cohort Study of the Hepatitis B Research 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