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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

Hepatology International volume 13, pages 431–439 (2019)Cite this article

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.

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Authors and Affiliations

  1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7 Chung-Shan South Road, Taipei, 100, Taiwan

    Yu-Shan Huang, Hsin-Yun Sun, Yu-Chung Chuang, Aristine Cheng, Yi-Ching Su, Wen-Chun Liu & Chien-Ching Hung

  2. Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan

    Sui-Yuan Chang

  3. Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Sui-Yuan Chang

  4. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan

    Sung-Hsi Huang & Yi-Chia Huang

  5. Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan

    Sung-Hsi Huang & Chien-Ching Hung

  6. Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan

    Guan-Jhou Chen

  7. Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan

    Kuan-Yin Lin

  8. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan

    Chien-Ching Hung

  9. China Medical University, Taichung, Taiwan

    Chien-Ching Hung

Authors
  1. Yu-Shan Huang
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Corresponding author

Correspondence to Chien-Ching Hung.

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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.

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

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Huang, YS., Sun, HY., Chang, SY. et al. 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. Hepatol Int 13, 431–439 (2019). https://doi.org/10.1007/s12072-019-09953-4

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