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Long-term virological and serologic responses of chronic hepatitis B virus infection to tenofovir disoproxil fumarate-containing regimens in patients with HIV and hepatitis B coinfection

  • Yu-Shan Huang
  • Hsin-Yun Sun
  • Sui-Yuan Chang
  • Yu-Chung Chuang
  • Aristine Cheng
  • Sung-Hsi Huang
  • Yi-Chia Huang
  • Guan-Jhou Chen
  • Kuan-Yin Lin
  • Yi-Ching Su
  • Wen-Chun Liu
  • Chien-Ching HungEmail author
Original Article
  • 110 Downloads

Abstract

Background

Data regarding the durability of HBV viral suppression with combination antiretroviral therapy (cART) containing tenofovir disoproxil fumarate (TDF) combined with lamivudine (3TC) or emtricitabine (FTC) in HIV/HBV-coinfected patients are scarce in hyperendemic areas of chronic HBV infection.

Methods

Between 2004 and 2016, HIV/HBV-coinfected Taiwanese with available baseline HBV DNA load were retrospectively reviewed. Determinations of plasma HBV DNA load, HBV serologic markers (HBsAg, anti-HBs, HBeAg, and anti-HBe), and liver function were performed after initiation of cART. Factors associated with time to undetectable HBV DNA load were explored.

Results

A total of 366 patients were included according to cART history: Group 1, 3TC as the only anti-HBV therapy (n = 73); Group 2, TDF-containing cART as initial therapy (n = 127); and Group 3, switch of 3TC-based to TDF-containing cART (n = 166). At year 5, HBV suppression was achieved in 77.8%, 95.7%, and 95.7% of Groups 1, 2 and 3, respectively. In multivariate Cox regression analysis, TDF ( ± 3TC or FTC) but not 3TC alone as initial anti-HBV therapy was significantly associated with HBV suppression (adjusted hazard ratio [aHR] 2.635; 95% CI 1.720–4.037), while HBeAg positivity at baseline was associated with failure to achieve HBV suppression (aHR 0.293; 95% CI 0.178–0.482). Loss of HBsAg occurred in 15 patients (4.1%), with 7 (1.9%) seroconversion to anti-HBs positivity, while HBeAg seroconversion occurred in 11 (16.9%) of 65 HBeAg-positive patients.

Conclusions

TDF-containing cART achieved durable HBV viral suppression in HIV/HBV-coinfected patients and HBeAg positivity at baseline was associated with failure to achieve HBV suppression despite long-term TDF-containing cART.

Keywords

Chronic hepatic complications Liver fibrosis Lamivudine Emtricitabine Tenofovir Nucleotide reverse-transcriptase inhibitor 

Notes

Compliance with ethical standards

Conflict of interest

C.-C. H. has received research support from Gilead Sciences, Merck, and ViiV and speaker honoraria from Gilead Sciences and ViiV, and served on the advisory boards for Gilead Sciences and ViiV. Yu-Shan Huang, Hsin-Yun Sun, Sui-Yuan Chang, Yu-Chung Chuang, Aristine Cheng, Sung-Hsi Huang, Yi-Chia Huang, Guan-Jhou Chen, Kuan-Yin Lin, Yi-Ching Su, Wen-Chun Liu have no conflicts of interest.

Ethical approval

The study was approved by the NTUH Research Ethics Committee (registration number, NTUH-201201028RIB).

Informed consent

The written or oral informed consent was waived.

Supplementary material

12072_2019_9953_MOESM1_ESM.docx (20 kb)
Supplementary file1 (DOCX 20 kb)

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Copyright information

© Asian Pacific Association for the Study of the Liver 2019

Authors and Affiliations

  • Yu-Shan Huang
    • 1
  • Hsin-Yun Sun
    • 1
  • Sui-Yuan Chang
    • 2
    • 3
  • Yu-Chung Chuang
    • 1
  • Aristine Cheng
    • 1
  • Sung-Hsi Huang
    • 4
    • 5
  • Yi-Chia Huang
    • 4
  • Guan-Jhou Chen
    • 6
  • Kuan-Yin Lin
    • 7
  • Yi-Ching Su
    • 1
  • Wen-Chun Liu
    • 1
  • Chien-Ching Hung
    • 1
    • 5
    • 8
    • 9
    Email author
  1. 1.Department of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
  2. 2.Department of Clinical Laboratory Sciences and Medical BiotechnologyNational Taiwan University College of MedicineTaipeiTaiwan
  3. 3.Department of Laboratory MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
  4. 4.Department of Internal MedicineNational Taiwan University Hospital Hsin-Chu BranchHsin-ChuTaiwan
  5. 5.Department of Tropical Medicine and ParasitologyNational Taiwan University College of MedicineTaipeiTaiwan
  6. 6.Department of Internal MedicineNational Taiwan University Hospital Yun-Lin BranchYun-Lin CountyTaiwan
  7. 7.Department of MedicineNational Taiwan University Hospital Jin-Shan BranchNew Taipei CityTaiwan
  8. 8.Department of Medical ResearchChina Medical University HospitalTaichungTaiwan
  9. 9.China Medical UniversityTaichungTaiwan

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