HBcAb positivity increases the risk of severe hepatic fibrosis development in HIV-HCV-positive subjects from the ICONA Italian cohort of HIV-infected patients

The aim of this study was to investigate the impact of HBcAb positivity on the progression of liver fibrosis (Fibrosis-4 score> 3.25) in the Italian cohort of HIV-infected individuals naïve to antiretroviral treatment (ICONA). All patients with FIB-4 <3.25 at baseline were evaluated prospectively: 6966 PLWH (People Living with HIV) patients were screened and classified based on HBV and HCV serology. Patients who were HBcAb+/HCV-/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 <0.0001). 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> 3.25 in HCV+/HBcAb+/HBsAg- patients (HR 7.2, 95% CI 3 8 -13.64).HBcAb+ contribute 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.