Hepatitis B Virus Activation among Central Africans Infected with Human Immunodeficiency Virus (HIV) Type 1: Pre-s2 Antigen Is Predominantly Expressed in HIV Infection

To evaluate the impact of human immunodeficiency virus (HIV) type 1 on the natural history of hepatitis B virus (HBV) infection, sera from Central Africans with and without antibodies to HIV were examined for HBV markers of ongoing replication, recovery from infection, and reactivation or reinfection. The prevalence of HBV infection and HBV surface antigen (HBsAg) was similar for HIV-positive and -negative persons. AIDS patients were more likely to be HBsAg positive and have markers of viral replication. Unlike pre-surface (pre-s) 1 antigen (Ag), which did not differ significantly with respect to HIV infection, pre-s2Ag was more common among HIV-positive persons than among HIV-negative ones and was more common among AIDS patients than among HIV-positive asymptomatic carriers. HIV-positive persons had more markers consistent with HBV reactivation and lower levels of antibody to HBsAg.