BACKGROUND: The impact of antiretroviral therapy (ART) interruption in HIV-hepatitis B virus (HBV)-coinfected patients was examined in the Strategic Management of AntiRetroviral Therapy (SMART) study. METHODS: Plasma HBV DNA was measured in all hepatitis B surface antigen-positive (HBV-positive) participants at baseline, and at months 1, 2, 4, 6, 8, 10, and 12. RESULTS: Among HBV-positive participants in the ART interruption (drug conservation) (n = 72) and ART continuation (virological suppression) (n = 62) arms, HBV DNA rebound of more than 1 log from baseline at months 1-4 was seen in 31-33% (P = 0.003) and 3-4% (P = 0.017), respectively. Thirteen HBV-positive participants had HBV DNA rebound of more than 3 log, including 12 in the drug conservation arm, of which eight were on tenofovir-containing regimens. Factors independently associated with a HBV DNA rebound were drug conservation arm (P = 0.0002), nondetectable HBV DNA at baseline (P = 0.007), and black race (P = 0.03). Time to ART reinitiation was shorter (7.5, 15.6, and 17.8 months; P < 0.0001) and proportion reinitiating greater (62.5, 46.5, and 39.7%; P = 0.0002) among HBV-positive participants as compared with hepatitis C virus-positive and non-HBV/hepatitis C virus participants in the drug conservation arm. No hepatic decompensation events occurred among HBV-positive participants in either arm. CONCLUSION: HBV DNA rebound following ART interruption is common and may be associated with accelerated immune deficiency in HIV-HBV-coinfected patients.
BACKGROUND: The impact of antiretroviral therapy (ART) interruption in HIV-hepatitis B virus (HBV)-coinfected patients was examined in the Strategic Management of AntiRetroviral Therapy (SMART) study. METHODS: Plasma HBV DNA was measured in all hepatitis B surface antigen-positive (HBV-positive) participants at baseline, and at months 1, 2, 4, 6, 8, 10, and 12. RESULTS: Among HBV-positive participants in the ART interruption (drug conservation) (n = 72) and ART continuation (virological suppression) (n = 62) arms, HBV DNA rebound of more than 1 log from baseline at months 1-4 was seen in 31-33% (P = 0.003) and 3-4% (P = 0.017), respectively. Thirteen HBV-positive participants had HBV DNA rebound of more than 3 log, including 12 in the drug conservation arm, of which eight were on tenofovir-containing regimens. Factors independently associated with a HBV DNA rebound were drug conservation arm (P = 0.0002), nondetectable HBV DNA at baseline (P = 0.007), and black race (P = 0.03). Time to ART reinitiation was shorter (7.5, 15.6, and 17.8 months; P < 0.0001) and proportion reinitiating greater (62.5, 46.5, and 39.7%; P = 0.0002) among HBV-positive participants as compared with hepatitis C virus-positive and non-HBV/hepatitis C virus participants in the drug conservation arm. No hepatic decompensation events occurred among HBV-positive participants in either arm. CONCLUSION: HBV DNA rebound following ART interruption is common and may be associated with accelerated immune deficiency in HIV-HBV-coinfected patients.
Authors: Julie Sheldon; Nuria Camino; Berta Rodés; Angeline Bartholomeusz; Michael Kuiper; Frank Tacke; Marina Núñez; Stefan Mauss; Thomas Lutz; Gerd Klausen; Stephen Locarnini; Vincent Soriano Journal: Antivir Ther Date: 2005
Authors: Deborah Konopnicki; Amanda Mocroft; S de Wit; Francisco Antunes; Bruno Ledergerber; Christine Katlama; K Zilmer; Stefano Vella; Ole Kirk; Jens D Lundgren Journal: AIDS Date: 2005-03-24 Impact factor: 4.177
Authors: Gail V Matthews; Angeline Bartholomeusz; Stephen Locarnini; Anna Ayres; Joe Sasaduesz; Eric Seaberg; David A Cooper; Sharon Lewin; Gregory J Dore; Chloe L Thio Journal: AIDS Date: 2006-04-04 Impact factor: 4.177
Authors: W M El-Sadr; J D Lundgren; J D Neaton; F Gordin; D Abrams; R C Arduino; A Babiker; W Burman; N Clumeck; C J Cohen; D Cohn; D Cooper; J Darbyshire; S Emery; G Fätkenheuer; B Gazzard; B Grund; J Hoy; K Klingman; M Losso; N Markowitz; J Neuhaus; A Phillips; C Rappoport Journal: N Engl J Med Date: 2006-11-30 Impact factor: 91.245
Authors: Moira A McMahon; Benjamin L Jilek; Timothy P Brennan; Lin Shen; Yan Zhou; Megan Wind-Rotolo; Sifei Xing; Shridhar Bhat; Braden Hale; Robert Hegarty; Curtis R Chong; Jun O Liu; Robert F Siliciano; Chloe L Thio Journal: N Engl J Med Date: 2007-06-21 Impact factor: 91.245
Authors: Helen M Chun; Mollie P Roediger; Katherine Huppler Hullsiek; Chloe L Thio; Brian K Agan; William P Bradley; Sheila A Peel; Linda L Jagodzinski; Amy C Weintrob; Anuradha Ganesan; Glenn Wortmann; Nancy F Crum-Cianflone; Jason D Maguire; Michael L Landrum Journal: J Infect Dis Date: 2011-12-05 Impact factor: 5.226
Authors: Robert C Bollinger; Chloe L Thio; Mark S Sulkowski; Jane McKenzie-White; David L Thomas; Charles Flexner Journal: Lancet HIV Date: 2019-12-20 Impact factor: 12.767
Authors: Bret J Rudy; Bill G Kapogiannis; Michelle A Lally; Glenda E Gray; Linda-Gail Bekker; Paul Krogstad; Ian McGowan Journal: J Acquir Immune Defic Syndr Date: 2010-07 Impact factor: 3.731
Authors: Vincent Soriano; Pablo Labarga; Carmen de Mendoza; José M Peña; José V Fernández-Montero; Laura Benítez; Isabella Esposito; Pablo Barreiro Journal: Curr HIV/AIDS Rep Date: 2015-09 Impact factor: 5.071
Authors: J S Hafkin; M K Osborn; A R Localio; V K Amorosa; J R Kostman; J J Stern; P De La Torre; K Mounzer; I Frank; R Gross; K-M Chang; V Lo Re Journal: J Viral Hepat Date: 2013-07-30 Impact factor: 3.728