Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Epidemiology, diagnosis and treatment of chronic hepatitis B in HIV-infected patients (EPIB 2005 STUDY) Lionel Piroth a , Damien Se `ne b,c , Stanislas Pol d , Isabelle Goderel e , Karine Lacombe f , Benoit Martha a , David Rey g , Ve ´ronique Loustau-Ratti h , Jean-Franc ¸ois Bergmann j , Gilles Pialoux k , Anne Gervais l , Caroline Lascoux-Combe m , Fabrice Carrat e and Patrice Cacoub b,c for the GERMIVIC Study Group M Objective: To describe the characteristics of hepatitis B (HBV) infection in HIV-infected patients and the impact of anti-HBV treatments. Patients and methods: All the patients with past or present chronic HBV infection seen in October 2005 in 17 French hospitals were included. Data were retrospectively collected from their first visit in a time-dependent manner, through a detailed standardized questionnaire. Results: Among 477 HBV-infected patients, 261 (55%) were co-infected with HIV. The HBV–HIV co-infected patients underwent fewer serological, virological and histologi- cal evaluations. Initial positive HBe antigenemia (HBe Ag) was more frequent in these patients (57.9 versus 28.6%; P < 10 4 ), as was cirrhosis on the initial liver biopsy (17.9 versus 7.6%; P ¼ 0.05). Throughout the mean 5-year follow-up, HBe Ag loss was less frequent (P ¼ 0.04), as was HBe seroconversion (incidence rate 2.6 versus 10/100 patient-years; P < 10 3 ). HBe Ag loss was associated with fibrosis improvement (METAVIR score 0.5  0.4 versus þ0.2  0.6 if persistent positive HBe Ag, P ¼ 0.01). In co-infected patients on tenofovir, adefovir or interferon, HBe seroconversions were seen in patients on combined HBV treatment, the use of which is increasing (58% in 2005). Nevertheless, no significant difference in virological, immunological or biochemical evolution was observed between these different treatments. Conclusions: In HBV–HIV co-infected patients, the assessment of HBV infection still needs to be improved, the HBV wild-type remains predominant, and HBe Ag loss is rare and associated with a better histological evolution. There is insufficient evidence of the superiority of combined HBV treatment, and this still needs be demonstrated in long term studies. ß 2007 Lippincott Williams & Wilkins AIDS 2007, 21:1323–1331 Keywords: hepatitis B virus, HIV, co-infection, treatment, evolution From the a CHU, Dijon, the b Universite ´ Pierre et Marie Curie-Paris 6, CNRS, UMR 7087, Paris, the c AP-HP, Ho ˆ pital Pitie ´-Salpe ˆtrie `re, Service de Me ´decine Interne, Paris, the d CHU Cochin, Paris, the e Inserm U707, Paris, the f CHU Saint-Antoine, Paris, the g CHU, Strasbourg, the h CHU, Limoges, the j CHU Lariboisie `re, Paris, the k CHU Tenon, Paris, the l CHU Bichat, Paris, and the m CHU Saint-Louis, Paris, France. Correspondence to Professor Lionel Piroth, MD, PhD, Service de Maladies Infectieuses et Tropicales, CHU Dijon, 10 boulevard du Mare ´chal de Lattre de Tassigny, 21079 Dijon Cedex, France. E-mail: lionel.piroth@chu-dijon.fr  See list preceding References. Preliminary data of the present article were presented as a poster (number 1318) at the 57 th AASLD meeting, 27 – 31 October 2006, Boston, Massachusetts, USA. Received: 13 November 2006; revised: 30 January 2007; accepted: 2 February 2007. ISSN 0269-9370 Q 2007 Lippincott Williams & Wilkins 1323