ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Hepatitis B Reactivation in a US Cohort of People With HIV and Hepatitis B Core Antibody After Switch to Antiretroviral Therapy Without Hepatitis B Activity.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Clinically Relevant Risk of Hepatitis B Virus Infection and Reactivation in People With HIV After Withdrawal of Anti-HBV-Active Antiretroviral Therapy in Japan.Open forum infectious diseases · 2026Article
- Hepatitis B virus outcomes in people with HIV after cessation of tenofovir-containing antiretroviral therapy: a systematic review and meta-analysis.EClinicalMedicine · 2026Article
- HBV Serological Profiles and Vaccination Status in People with HIV in the Transition to a Tenofovir-Sparing Era: Insights from a Large HIV Cohort.Infectious diseases and therapy · 2026Article
- A Quality Improvement Pilot to Increase Hepatitis B Screening and Optimize Patient Selection for the Switch to Two-Drug Antiretroviral Regimens in People With HIV.Open forum infectious diseases · 2025Article
- Enhancing Hepatitis B Virus Vaccine Uptake and Immunity Through Long-Acting Antiretroviral Therapy Programmatic Synergy in the US South.Open forum infectious diseases · 2025Article
- Hepatitis B Virus DNA and RNA Persist in Liver After Serologic Recovery in Persons With Hepatitis C Virus.The Journal of infectious diseases · 2024Article
- Hepatitis B Virus in People who Inject Drugs and Men who Have Sex With Men With HIV in India: A Cross-sectional Study.Open forum infectious diseases · 2024Article
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Abstract
backgroundOne in 3 people with human immunodeficiency virus (HIV-1; PWH) are hepatitis B (HBV) core antibody positive (anti-HBc+) and surface antigen negative (HBsAg-) suggesting prior exposure. HBV reactivation can occur in this group if nucleos(t)ide reverse transcriptase inhibitor antiretrovirals (ARV) active against both HIV and HBV are stopped. We describe HBV reactivation in anti-HBc+/HBsAg- PWH following switch from ARV with HBV activity to ARV without HBV activity.
methodsWe identified an at-risk cohort of 5986 anti-HBc+ participants switched from HBV-active to non-HBV-active ARV on or before 31 December 2023 and HBsAg- on the most recent result preceding switch from 63 153 PWH in the Veterans Aging Cohort Study. We defined HBV reactivation as HBV DNA detection or HBsAg+ result at any time following switch. HBV-active ARV included lamivudine, emtricitabine, or tenofovir.
resultsForty (0.67%) anti-HBc+/HBsAg- PWH experienced HBV reactivation after switch to non-HBV-active ARV, with median time to reactivation 8.9 months (interquartile range 5.5-26.7). The rate of HBV reactivation was 25.1 per 10 000 person-years (95% confidence interval [CI], 18.4-34.3). Prespecified subgroup analyses revealed higher rates per 10 000 person-years of HBV reactivation in those HBsAg+ in the remote past with no hepatitis B surface antibody positive (anti-HBs+) result (321; 95% CI, 120-855) versus subgroups never previously HBsAg+ or anti-HBs+ (38.0; 95% CI, 22.9-63.0), or anti-HBs+ but never HBsAg+ (17.4; 95% CI, 11.2-27.0).
conclusionsOverall risk of HBV reactivation appears low after switch from HBV-active to non-HBV-active ARV among anti-HBc+ PWH with no prior HBsAg+. Our results inform provider-patient discussion about HBV reactivation risk when considering ARV switching.
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