Characterization of HIV-HBV coinfection in a multinational HIV-infected cohort.

TitleCharacterization of HIV-HBV coinfection in a multinational HIV-infected cohort.
Publication TypeJournal Article
Year of Publication2013
AuthorsThio CL, Smeaton L, Saulynas M, Hwang H, Saravanan S, Saravan S, Kulkarni S, Hakim J, Nyirenda M, Iqbal HS, Lalloo UG, Mehta AS, Hollabaugh K, Campbell TB, Lockman S, Currier JS
JournalAIDS
Volume27
Issue2
Pagination191-201
Date Published2013 Jan 14
ISSN1473-5571
KeywordsAdult, Antiretroviral Therapy, Highly Active, Antiviral Agents, CD4 Lymphocyte Count, Cohort Studies, Coinfection, Female, Hepatitis B, Hepatitis B Surface Antigens, HIV Infections, Humans, Male, Randomized Controlled Trials as Topic, Regression Analysis, Viral Load
Abstract

OBJECTIVE: To understand the HIV-hepatitis B virus (HBV) epidemic from a global perspective by clinically and virologically characterizing these viruses at the time of antiretroviral therapy (ART) initiation in a multinational cohort.

METHODS AND DESIGN: HIV-infected patients enrolled in two international studies were classified as HIV-HBV coinfected or HIV monoinfected prior to ART. HIV-HBV coinfected patients were tested for HBV characteristics, hepatitis D virus (HDV), a novel noninvasive marker of liver disease, and drug-resistant HBV. Comparisons between discrete covariates used χ or Fisher's exact tests (and Jonchkheere-Terpstra for trend tests), whereas continuous covariates were compared using Wilcoxon Rank-Sum Test.

RESULTS: Of the 2105 HIV-infected patients from 11 countries, the median age was 34 years and 63% were black. The 115 HIV-HBV coinfected patients had significantly higher alanine aminotransferase and aspartate aminotransferase values, lower BMI, and lower CD4 T-cell counts than HIV monoinfected patients (median 159 and 137 cells/μl, respectively, P = 0.04). In the coinfected patients, 49.6% had HBeAg-negative HBV, 60.2% had genotype A HBV, and 13% were HDV positive. Of the HBeAg-negative patients, 66% had HBV DNA 2000 IU/ml or less compared to 5.2% of the HBeAg-positive individuals. Drug-resistant HBV was not detected.

CONCLUSION: Screening for HBV in HIV-infected patients in resource-limited settings is important because it is associated with lower CD4 T-cell counts. In settings in which HBV DNA is not available, HBeAg may be useful to assess the need for HBV treatment. Screening for drug-resistant HBV is not needed prior to starting ART in settings in which this study was conducted.

DOI10.1097/QAD.0b013e32835a9984
Alternate JournalAIDS
PubMed ID23032418
PubMed Central IDPMC3763734
Grant List1U01AI069399-01 / AI / NIAID NIH HHS / United States
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AL-27665 / / PHS HHS / United States
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IAA#Y1-AI-8374-01 / AI / NIAID NIH HHS / United States
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