HBcAb Positivity Increases the Risk of Severe Hepatic Fibrosis Development in HIV/HCV-Positive Subjects From the ICONA Italian Cohort of HIV-Infected Patients
Authors: Malagnino Vincenzo , Cerva Carlotta , Cingolani Antonella , Ceccherini-Silberstein Francesca , Vergori Alessandra , Cuomo Gianluca , Perno Carlo Federico , Puoti Massimo , d’Arminio Monforte Antonella , Cozzi-Lepri Alessandro , Andreoni Massimo , Sarmati Loredana ,   ICONA Foundation Study Group, 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 
Published: November 2020

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 &gt;3.25) in the Italian cohort of HIV-infected individuals naïve to antiretroviral treatment (ICONA).

Methods
All patients with FIB-4 &lt;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 &lt; .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 &gt;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.