Adherence to European AIDS clinical society hepatitis B management guidelines in people with HIV: real-world evidence from Spain and Germany
Objective: To evaluate adherence to hepatitis B virus (HBV) management recommendations among people with HIV (PWH) and chronic HBV infection. Design: A multicenter cross-sectional study. Methods: We conducted a cross-sectional study in 42 centers in Spain and Germany between June 2024 and March 2025. Chronic HBV infection was defined as at least two positive hepatitis B surface antigen tests obtained more than 6 months apart. Adherence to 2023 European AIDS Clinical Society recommendations regarding anti-HBV treatment, liver enzyme monitoring, HBV-DNA testing, antihepatitis D virus (HDV) screening, and HDV-RNA confirmation was assessed. Hepatocellular carcinoma surveillance was evaluated separately and has been reported elsewhere. Results: A total of 1235 PWH with chronic HBV infection were included. The median age was 56 years, 84% were men, and 36% were born outside Europe. Overall, 88% had HIV-RNA less than 50 copies/ml, and the median CD4 + cell count was 623 cells/μl. Among participants with available HBV-DNA result, 87% had undetectable HBV-DNA. Guideline-recommended anti-HBV treatment was documented in 88% of individuals. During the previous 12 months, liver enzyme monitoring was performed in 94% and HBV-DNA testing in 71%. Overall, 81% had ever undergone anti-HDV testing and, among anti-HDV-positive individuals, 66% had undergone HDV-RNA testing. Conclusion: Although adherence to several components of HBV care was high, gaps remain in the implementation of current recommendations for PWH, particularly in HBV-DNA monitoring and HDV evaluation. Better integration of these measures into routine HIV care may improve long-term prevention of liver-related complications.
Authors
- Roger Vogelmann (ORCID: https://orcid.org/0000-0001-5730-1558)
- Leire Pérez‐Latorre (ORCID: https://orcid.org/0000-0001-9919-3778)
- Oscar Luis Ferrero
- Jorge Alberto Sánchez Valencia (ORCID: https://orcid.org/0000-0002-0148-2422)
- Florian Voit (ORCID: https://orcid.org/0000-0002-6957-6628)
- Ian F. Haney Lopez (ORCID: https://orcid.org/0000-0001-7252-8961)
- Kathrin van Bremen (ORCID: https://orcid.org/0000-0002-6701-1084)
- Roser Navarro‐Soler (ORCID: https://orcid.org/0009-0001-7044-2707)
- Jakob J Malin (ORCID: https://orcid.org/0000-0002-2989-0436)
- Anders C. Boyd (ORCID: https://orcid.org/0000-0001-9512-8928)
- Rosario Palacios (ORCID: https://orcid.org/0000-0001-8839-3520)
- Stefan Mauss (ORCID: https://orcid.org/0009-0007-2657-3738)
- Antonio Rivero (ORCID: https://orcid.org/0000-0002-8643-4250)
- Sebastian Noé (ORCID: https://orcid.org/0000-0001-6863-3275)
- Pavel Khaykin (ORCID: https://orcid.org/0000-0002-8841-2485)
- Malte B. Monin (ORCID: https://orcid.org/0000-0002-8794-3612)
- Juncal Pérez‐Somarriba (ORCID: https://orcid.org/0000-0002-9623-5781)
- Luz Martı́n-Carbonero (ORCID: https://orcid.org/0000-0001-8102-4079)
- Jordi Navarro (ORCID: https://orcid.org/0000-0002-7187-0367)
- Stephan M. Schneeweiß
- Peré Domingo (ORCID: https://orcid.org/0000-0003-1138-5770)
- Stefan Eßer (ORCID: https://orcid.org/0000-0002-3625-9650)
- Carmen Hidalgo-Tenorio (ORCID: https://orcid.org/0000-0002-6394-5728)
- Daniel T. Beer
- Christoph Wyen (ORCID: https://orcid.org/0000-0001-5158-5473)
- Fauzi M A Elamouri
- Alexander Killer (ORCID: https://orcid.org/0009-0004-8427-0266)
- María José Galindo
- Jose M. Bellón
- Annette Haberl (ORCID: https://orcid.org/0009-0001-1916-7981)
- Marta de Miguel
- Ignacio De Los Santos (ORCID: https://orcid.org/0000-0001-7073-5211)
- Pablo Ryan (ORCID: https://orcid.org/0000-0002-4212-7419)
- Axel Baumgarten
- Nazifa Qurishi
- J Rockstroh
- Juan Berenguer (ORCID: https://orcid.org/0000-0001-8541-8200)
- Sergio Reus
- Marta Montero
- Thomas Lutz
- María J. Vivancos
- Xavier Camino
- José Sanz
- María C. Fariñas
- Luis E. Morano
Institutions
- University of Bern (CH)
- University Medical Center Groningen (NL)
- University of Cologne (DE)
- Instituto Cajal (ES)
- University Hospital Bonn (DE)
- Hospital Universitario La Paz (ES)
- University Hospital of Bern (CH)
- Hospital de Sant Pau (ES)
- University Hospital Complex Of Vigo (ES)
- Hospital General Universitario Gregorio Marañón (ES)
- Hospital Clínico San Carlos (ES)
- Hospital Universitari i Politècnic La Fe (ES)
- Düsseldorf University Hospital (DE)
- Hospital de Basurto (ES)
- Hospital Clínico Universitario de Valencia (ES)
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (ES)
- Biogipuzkoa Health Research Institute (ES)
- Hospital Universitario 12 De Octubre (ES)
- Vall d'Hebron Institut de Recerca (ES)
- Hospital La Paz Institute for Health Research (ES)
- Hospital Universitario Príncipe de Asturias (ES)
- University Medical Center Hamburg-Eppendorf (DE)
- Instituto de Investigación Marqués de Valdecilla (ES)
- Centro de Investigación Biomédica en Red (ES)
- Hospital Universitario Virgen de las Nieves (ES)
- Essen University Hospital (DE)
- Fundación Seimc-Gesida (ES)
- Hospital Universitario Reina Sofía (ES)
- Hospital Universitario Doctor Peset (ES)
- Instituto Ramón y Cajal de Investigación Sanitaria (ES)
- Vall d'Hebron Hospital Universitari (ES)
- Center for HIV and Hepatogastroenterology (DE)
- Hospital Universitario de La Princesa (ES)
- University Hospital Frankfurt (DE)
- Praxis für Humangenetik (DE)
- University Hospital Cologne (DE)
- Hospital Clínico Universitario Virgen de la Victoria (ES)
- Hospital Universitario Ramón y Cajal (ES)
- Hospital Universitario Infanta Leonor (ES)
- Centro de Investigación Biomédica en Red Enfermedades Infecciosas (ES)
- Heinrich Heine University Düsseldorf (DE)
- University of Duisburg-Essen (DE)
Publication Details
- Journal
- AIDS
- Published
- 2026-10-08
- DOI
- https://doi.org/10.1097/qad.0000000000004635
- Primary Topic
- Hepatitis B Virus Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00