Hepatitis B surface antigen quantification as a predictor of seroclearance during treatment in HIV‐hepatitis B virus coinfected patients from Sub‐Saharan Africa

Boyd, Anders; Maylin, Sarah; Moh, Raoul; Mahjoub, Nadia; Gabillard, Delphine; Eholié, Serge; Danel, Christine; Anglaret, Xavier; Zoulim, Fabien; Girard, Pierre‐Marie; Delaugerre, Constance; Lacombe, Karine

doi:10.1111/jgh.13156

Cited by 29 publications

(33 citation statements)

References 36 publications

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“…The high and rapid HBsAg loss might be partly due to genotypes A and D, which have been associated with a rapid initial HBsAg reduction that correlates with HBsAg loss [38]. The study conducted in South Africa and Zambia also had a higher HBsAg loss (18%) within 12 months [35] compared to studies such as those in the Ivory Coast, where HBsAg loss was as low as 6.2% after a median of 12.3 months on treatment [39], but it was lower than this cohort. The difference might be the differences in genotypes because 22% of the Hamers study were genotype E [35].…”

Section: Discussionmentioning

confidence: 99%

Slow CD4+ T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana

Anderson

Gaseitsiwe

Moyo

et al. 2016

Open Forum Infectious Diseases

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Background. Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection has emerged as an important cause of morbidity and mortality. We determined the response to Truvada-based first-line combination antiretroviral therapy (cART) in HIV/HBV-coinfected verus HIV-monoinfected patients in Botswana.Methods. Hepatitis B virus surface antigen (HBsAg), HBV e antigen (HBeAg), and HBV deoxyribonucleic acid (DNA) load were determined from baseline and follow-up visits in a longitudinal cART cohort of Truvada-based regimen. We assessed predictors of HBV serostatus and viral suppression (undetectable HBV DNA) using logistic regression techniques.Results. Of 300 participants, 28 were HBsAg positive, giving an HIV/HBV prevalence of 9.3% (95% confidence interval [CI], 6.3–13.2), and 5 of these, 17.9% (95% CI, 6.1–36.9), were HBeAg positive. There was a reduced CD4+ T-cell gain in HIV/HBV-coinfected compared with HIV-monoinfected patients. Hepatitis B virus surface antigen and HBeAg loss was 38% and 60%, respectively, at 24 months post-cART initiation. The HBV DNA suppression rates increased with time on cART from 54% to 75% in 6 and 24 months, respectively.Conclusions. Human immunodeficiency virus/HBV coinfection negatively affected immunologic recovery compared with HIV-1C monoinfection. Hepatitis B virus screening before cART initiation could help improve HBV/HIV treatment outcomes and help determine treatment options when there is a need to switch regimens.

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Section: Discussionmentioning

confidence: 99%

Slow CD4+ T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana

Anderson

Gaseitsiwe

Moyo

et al. 2016

Open Forum Infectious Diseases

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“…In studies of HIV-HBV co-infection up to 22% of participants lost HBsAg, depending on duration of follow up [36, 110–118] . A higher frequency of HBsAg loss has been associated with lower CD4+ T cell count prior to initiation of HBV-active ART [114, 115, 117] and a greater increase in CD4+ T-cells following ART [115, 118] but many of these studies were retrospective or didn’t include individuals with low CD4+ T-cells prior to ART.…”

Section: Natural History Of Hiv-hbv Co-infection In the Era Of Hbvmentioning

confidence: 99%

“…HBsAg loss following treatment of HIV-HBV co-infection has also been associated with low HBsAg levels at baseline or with a larger decline post treatment [110, 114, 116, 117, 120] although this has largely been described in HBeAg-positive disease [114, 116] and paradoxically associated with higher baseline HBV DNA [114, 115] . In HIV-HBV HBeAg negative disease, pretreatment HBsAg level of ≤100 IU/ mm 3 was predictive of HBsAg loss.…”

Section: Natural History Of Hiv-hbv Co-infection In the Era Of Hbvmentioning

confidence: 99%

HIV-hepatitis B virus coinfection

Singh¹,

Crane

Audsley

et al. 2017

Aids

191

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HIV infection has a significant impact on the natural history of chronic HBV infection, with increased levels of HBV DNA, accelerated progression of liver disease and increased liver-associated mortality compared to HBV mono-infection. Widespread uptake and early initiation of HBV-active antiretroviral therapy (ART) has substantially improved the natural history of HIV-HBV co-infection but the prevalence of liver disease remains elevated in this population. In this paper, we review recent studies examining the natural history and pathogenesis of liver disease and seroconversion in HIV-HBV co-infection in the era of HBV-active ART and the effects of HIV directly on liver disease. We also review novel therapeutics for the management of HBV with a particular emphasis on clinical strategies being developed for an HBV cure and an HIV cure and their impact on HIV-HBV co-infected individuals.

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“…In therapeutic trials of lamivudine- or TDF-containing cART, HBeAg seroconversion rates among HIV/HBV-coinfected patients ranged from 17 to 46% after 2 to 5 years of cART [28, 31–33]. In our study, 5 of 32 (15.6%) patients with available data had HBeAg seroconversion at week 48.…”

Section: Discussionmentioning

confidence: 60%

Virological Response to Tenofovir Disoproxil Fumarate in HIV-Positive Patients with Lamivudine-Resistant Hepatitis B Virus Coinfection in an Area Hyperendemic for Hepatitis B Virus Infection

et al. 2016

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BackgroundSequential addition of tenofovir disoproxil fumarate (TDF) is often needed for patients coinfected with HIV and hepatitis B virus (HBV) who develop HBV resistance to lamivudine after combination antiretroviral therapy (cART) containing only lamivudine for HBV. We aimed to assess the virological response of HBV to add-on TDF in patients coinfected with lamivudine-resistant HBV.MethodsBetween November 2010 and December 2014, 33 HIV/HBV-coinfected patients with lamivudine-resistant HBV and 56 with lamivudine-susceptible HBV were prospectively included. TDF plus lamivudine was used to substitute zidovudine or abacavir plus lamivudine contained in cART in patients with lamivudine-resistant HBV infection, while patients with lamivudine-susceptible HBV infection received TDF plus lamivudine as backbone of cART. Serial determinations of plasma HBV DNA load, HBV serologic markers, and liver and renal functions were performed after initiation of TDF-containing cART.ResultsOf 89 patients included, 38.6% tested positive for HBV envelope antigen (HBeAg) at baseline. The plasma HBV DNA level at enrollment of lamivudine-resistant and lamivudine-susceptible group were 6.1 ± 2.2 log10 and 6.0 ± 2.2 log10 copies/mL, respectively (p = 0.895). The cumulative percentage of HBV viral suppression in lamivudine-resistant and lamivudine-susceptible group was 81.8% and 91.1% at 48 weeks, respectively (p = 0.317), which increased to 86.7% and 96.2% at 96 weeks, respectively (p = 0.185). At 48 weeks, 11 patients testing HBeAg-positive at baseline failed to achieve viral suppression. In multivariate analysis, the only factor associated with failure to achieve viral suppression at 48 weeks was higher HBV DNA load at baseline (odds ratio, per 1-log10 copies/mL increase, 1.861; 95% CI, 1.204–2.878). At 48 weeks, HBeAg seroconversion was observed in 5 patients (1 in the lamivudine-resistant group and 4 in the lamivudine-susceptible group; p = 0.166). During the study period, HBsAg levels decreased over time, regardless of lamivudine resistance. Loss of HBsAg was observed in 3 (3.4%) patients in the lamivudine-susceptible group.ConclusionsAdd-on TDF-containing cART in patients coinfected with lamivudine-resistant HBV achieved a similar rate of HBV viral suppression compared to TDF-containing cART as initial regimen in patients coinfected with lamivudine-susceptible HBV. A higher baseline HBV DNA load and HBeAg positivity were associated with failure to achieve HBV viral suppression.

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Hepatitis B surface antigen quantification as a predictor of seroclearance during treatment in HIV‐hepatitis B virus coinfected patients from Sub‐Saharan Africa

Cited by 29 publications

References 36 publications

Slow CD4+ T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana

Slow CD4+ T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana

HIV-hepatitis B virus coinfection

Virological Response to Tenofovir Disoproxil Fumarate in HIV-Positive Patients with Lamivudine-Resistant Hepatitis B Virus Coinfection in an Area Hyperendemic for Hepatitis B Virus Infection

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