Association Between HIV-1 RNA Detection Status and HBV DNA Detection: A Patient-Level Retrospective Longitudinal Molecular Study from Istanbul, Türkiye.

Background/

Objectives

HIV and hepatitis B virus (HBV) share major transmission routes and may coexist in the same individual, making coordinated molecular assessment clinically important.

Methods

This retrospective longitudinal laboratory-based study evaluated the patient-level association between HIV-1 RNA detection and HBV DNA detection using routine molecular testing data from a tertiary-care hospital in Istanbul, Türkiye. HIV-1 RNA and HBV DNA results obtained between 1 January 2022 and 1 August 2026 were linked at the patient level. A total of 5303 unique patients had HIV-1 RNA testing and 30,981 unique patient records had HBV DNA testing; these were separate source populations, and 529 individuals with results available for both molecular assays constituted the primary analytical cohort.

Results

Among the 529 patients, HIV-1 RNA was detected at least once in 246 (46.5%), while HBV DNA was detected at least once in 147 (27.8%). HBV DNA detection occurred in 83/246 (33.7%) patients with at least one detectable HIV-1 RNA result and in 64/283 (22.6%) patients with no detectable HIV-1 RNA in any available measurement (OR, 1.74; 95% CI, 1.19-2.56; p = 0.005). However, the association was attenuated after adjustment for age and sex and was no longer statistically significant (adjusted OR, 1.28; 95% CI, 0.84-1.94; p = 0.255). HIV-1 RNA magnitude and HIV-1 RNA categories were not significantly associated with HBV DNA detection, and no significant correlation was observed between same-day HIV-1 RNA and HBV DNA levels (Spearman's ρ = 0.161; p = 0.387) or between the nearest quantitative measurements obtained within ±30 days (ρ = 0.171; p = 0.245). Because treatment exposure and adherence information were unavailable, the observed molecular patterns could not be interpreted as direct measures of treatment response or treatment failure.

Conclusions

These findings indicate that HIV-1 RNA detection status or magnitude should not be used as a surrogate for HBV DNA detection and support independent, clinically indicated HBV assessment in people living with HIV.