in reply to Re^4: XML::Twig - setting text and elements
in thread XML::Twig - setting text and elements

Aha! I figured it out:

$topicref->set_content(@$h);

Result:

<xref href="../com.ibm.sqls.doc/ids_sqs_0147.dita#ids_sqs_0147"> <keyword conref="ds"/> Database-<b>level</b> privileges </xref>

Thanks for the suggestions.