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
- 110 Downloads
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.
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.
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.
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.
KeywordsChronic hepatic complications Liver fibrosis Lamivudine Emtricitabine Tenofovir Nucleotide reverse-transcriptase inhibitor
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.
The study was approved by the NTUH Research Ethics Committee (registration number, NTUH-201201028RIB).
The written or oral informed consent was waived.
- 7.Panel on Antiretroviral Guidelines for Adults and Adolescents (2018) Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. Department of Health and Human Services. https://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf. Accessed 26 May 2019.
- 13.Kang M, Hollabaugh K, Pham V, et al. Virologic and serologic outcomes of mono versus dual HBV therapy and characterization of HIV/HBV coinfection in a US cohort. J Acquir Immune Defic Syndr. 2014;66(2):172–80.Google Scholar
- 29.Agarwal K, Brunetto M, Seto WK, et al (2018) 96 weeks treatment of tenofovir alafenamide vs. tenofovir disoproxil fumarate for hepatitis B virus infection. J Hepatol 68(4):672–681Google Scholar