BACKGROUND: It is unknown how past and active hepatitis B virus (HBV) infection affect immunorecovery and mortality in people with HIV who initiate tenofovir-based anti-retroviral therapy (ART). METHODS: Using data collected between 2008- 2015, we studied people with HIV in sub-Saharan Africa initiating immediate ART in the Temprano randomized control trial. We classified participants into HBV groups at ART-initiation: hepatitis B surface antigen (HBsAg)-positive with HBV DNA ≥2000 IU/mL; HBsAg-positive with HBV DNA <2000 IU/ml; isolated HBcAb-positive; resolved infection (HBsAb-positive/HBcAb-positive); and HBV non-immune/vaccinated (HBcAb-). We compared square-root CD4-cell count increases using a mixed-effect, non-linear regression adjusted for age, sex, baseline CD4 cell count, and HIV RNA. We compared all-cause mortality using Bayesian parametric survival regression. RESULTS: Among 879 participants, 24 (2.7%) had HBsAg with high HBV DNA, 76 (8.6%) HBsAg with low HBV DNA, 325 (37.0%) isolated anti-HBcAb, 226 (25.7%) resolved HBV infection, and 228 (25.9%) HBV non-immune/vaccinated. We found no significant difference in CD4 cell increases between the four HBV-infection groups after adjustment (p=0.16). Participants with HBsAg and high HBV DNA had the highest incidence of all-cause mortality [1.9/100 person-years, 95%Credibile Interval (CrI)=1.0-3.4]. By comparison, incidence rates of mortality were reduced by 57% (95%CrI=-79%,-13%), 60% (95%CrI=-82%,-12%), and 66% (95%CrI=-84%,-23%) in those who had isolated anti-HBcAb-positive, resolved HBV infection, and HBV non-immune/vaccinated, respectively. CONCLUSION: Individuals with HIV and past HBV infection or isolated anti-HBcAb-positive serology, much like HBV non-immune/vaccinated, experience lower mortality than those with HBsAg and high HBV DNA. Additional HBV-related management would not be necessary for these individuals.Read less <