Virologic and serologic outcomes of mono versus dual HBV therapy and characterization of HIV/HBV coinfection in a US cohort.

TitleVirologic and serologic outcomes of mono versus dual HBV therapy and characterization of HIV/HBV coinfection in a US cohort.
Publication TypeJournal Article
Year of Publication2014
AuthorsKang M, Hollabaugh K, Pham V, Koletar SL, Wu K, Smurzynski M, Aberg JA
JournalJ Acquir Immune Defic Syndr
Volume66
Issue2
Pagination172-80
Date Published2014 Jun 1
ISSN1944-7884
KeywordsAdenine, Adult, Antibodies, Viral, Antiretroviral Therapy, Highly Active, Antiviral Agents, CD4 Lymphocyte Count, Coinfection, Deoxycytidine, DNA, Viral, Emtricitabine, Female, Follow-Up Studies, Hepatitis B, Hepatitis B e Antigens, HIV Infections, Humans, Lamivudine, Logistic Models, Male, Middle Aged, Organophosphonates, Randomized Controlled Trials as Topic, Retrospective Studies, Tenofovir, United States
Abstract

OBJECTIVES: To characterize HIV/hepatitis B virus (HBV) coinfection in the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort and compare long-term HBV outcomes between regimens with 1 (MONO) or 2 (DUAL) anti-HBV agents.

DESIGN: A retrospective study of coinfected AIDS Clinical Trials Group Longitudinal Linked Randomized Trials subjects who received regimens containing anti-HBV agent(s).

METHODS: Stored samples at baseline and weeks 16, 32, 48, 144, and 240 were tested for HBV DNA, HBV e antigen (HBeAg), HBV e antibody (HBeAb), and hepatitis D virus (HDV) antibody. Resistance and genotype were tested in samples with HBV DNA >600 IU/mL. MONO versus DUAL analyses were limited to HBV treatment-naive subjects (Naive-MONO, Naive-DUAL).

RESULTS: Of 150 study subjects, median age was 40 years, 96% were male; 57% white, 26% black, 13% Hispanic. Baseline median CD4 was 224 cells per cubic millimeter, HIV RNA 4.48 log10 copies/mL, HBV DNA 6.30 log10 IU/mL; 59% HBeAg positive and 65% HBeAb negative; HBV genotypes A = 69%, G = 18%, D = 7%, <2% for A/G, B, C, F, H. Coinfection with HDV was 2%. There were 49 Naive-MONO (lamivudine) and 22 Naive-DUAL (11 lamivudine + tenofovir, 11 emtricitabine + tenofovir) with detectable HBV DNA. In the 240-week follow-up, HBV DNA suppression was not significantly higher in Naive-DUAL (P = 0.14); lower baseline HBV DNA (P < 0.01) was associated with suppression. Among 32 Naive-MONO subjects with detectable HBV DNA at baseline and results at week 48, 41% suppressed; among such 15 Naive-DUAL subjects, 53% suppressed. HBeAg and HBeAb analyses showed similar trends.

CONCLUSIONS: While consistent trends toward increased HBV DNA suppression, HBeAg loss and HBeAb seroconversion were observed in Naive-DUAL compared with Naive-MONO, they were not statistically significant. Overall, HDV coinfection was low.

DOI10.1097/QAI.0000000000000149
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID24694927
PubMed Central IDPMC4169110
Grant List5R21AI083106 / AI / NIAID NIH HHS / United States
AI069532 / AI / NIAID NIH HHS / United States
R21 AI083106 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI069532 / AI / NIAID NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States
UM1 AI069494 / AI / NIAID NIH HHS / United States
UM1 AI069532 / AI / NIAID NIH HHS / United States
UM1 AI106701 / AI / NIAID NIH HHS / United States
UM1AI068634 / AI / NIAID NIH HHS / United States
UM1AI068636 / AI / NIAID NIH HHS / United States