Immunological research landscapes and emerging immune mechanisms in HIV/HBV co-infection: a bibliometric analysis (2014-2024).

Background: HIV and hepatitis B virus (HBV) co-infection remains a major global health challenge and is characterized by profound immune dysregulation, including chronic immune activation, impaired antiviral immunity, and immune-mediated liver injury. With the widespread use of effective antiretroviral therapy, people living with HIV now experience prolonged survival, shifting clinical and research priorities toward long-term immunological consequences and chronic comorbidities such as HBV. Although a rapidly expanding body of literature has explored HIV/HBV co-infection, a comprehensive immunology-oriented overview of global research trends, collaborative structures, and evolving immune-related research themes is still lacking. Methods: Publications related to HIV/HBV co-infection published between 2014 and 2024 were retrieved from the Web of Science Core Collection and Scopus databases. After data cleaning and deduplication, 1,649 eligible records were included. Bibliometric analyses were performed using CiteSpace and VOSviewer to evaluate temporal publication trends, international and institutional collaboration networks, journal distributions, keyword co-occurrence patterns, citation bursts, and emerging research frontiers, with a particular focus on immune-related research themes and host-virus immune interactions. Results: The annual number of publications increased steadily over the study period, with a marked rise in citation activity after 2017, reflecting sustained and growing scientific interest in the immunopathogenesis of HIV/HBV co-infection. High-income countries, particularly the United States and Western Europe, dominated research output and held central positions in global collaboration networks, whereas high-burden regions, such as sub-Saharan Africa, increasingly contributed through international partnerships. Keyword co-occurrence and citation-burst analyses revealed a clear immunological thematic evolution: early studies focused on antiviral therapy and virological suppression, followed by increased attention to epidemiology and clinical guidelines, and more recently a pronounced shift toward immune-related outcomes. Emerging research hotspots increasingly emphasized CD4 Conclusions: Global research on HIV/HBV co-infection has evolved from predominantly treatment- and virology-focused studies toward immunology-driven, outcome-oriented, and translational research addressing long-term immune dysfunction and prognosis. Despite expanding international collaboration, substantial disparities persist between regions with high disease burden and those leading immunological research. These findings underscore the need for strengthened locally led, immunology-focused research, long-term cohort studies, and integrated immune-monitoring strategies to improve clinical outcomes for people living with HIV/HBV co-infection.