Anders Boyd1, Joël Gozlan, Patrick Miailhes, Caroline Lascoux-Combe, Manuela Sébire-Le Cam, Hayette Rougier, Fabien Zoulim, Pierre-Marie Girard, Karine Lacombe. 1. aINSERM, UMR_S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique bLaboratoire de Virologie, Hôpital Saint-Antoine, AP-HP cUPMC UMRS CR7, INSERM U1135 CIMI, Paris dCentre de Recherche sur le Cancer de Lyon, Equipes 15 et 16, INSERM, Unité 1052, CNRS, UMR 5286 eService des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon fService des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, APHP gDepartment of Infectious and Tropical Diseases, Saint-Antoine Hospital, AP-HP, Paris hHepatology Unit, Hospices Civils de Lyon iUniversité de Lyon, Lyon jSorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
Abstract
OBJECTIVE: This study determines rates and risk factors associated with hepatitis B surface antigen (HBsAg) and hepatitis B 'e' antigen (HBeAg) seroclearance, two important prognostic indicators during infection with hepatitis B virus (HBV), in a large contemporary cohort of patients coinfected with HIV-HBV. DESIGN: Prospective cohort study of predominately antiretroviral therapy (ART) experienced, coinfected patients. METHODS: Participants enrolled in the French HIV-HBV Cohort had complete HBV serological battery conducted at inclusion and every yearly visit. Piecewise-exponential survival models were used to determine risk factors associated with seroclearance. RESULTS: A total of 290 patients, of whom 151 (52.1%) were HBeAg positive, had been followed for a median 7.4 years (interquartile range [IQR] = 3.1-8.0). Tenofovir (TDF) containing ART became increasingly more frequent, as rates of undetectable HBV-DNA increased accordingly (at baseline = 39.3%, end of follow-up = 91.0%). In HBeAg-positive patients, 60 of 151 had HBeAg seroclearance (cumulative 46.4% at end of follow-up) after a median 3.0 years (IQR = 2.0-4.9). Overall, 17 of 290 patients had HBsAg seroclearance (cumulative 7.4% at end of follow-up) after a median 4.6 years (IQR = 2.1-7.2). Lower levels of time-averaged cumulative HBV-DNA were significantly associated with both HBeAg and HBsAg seroclearance (P < 0.001 and P = 0.01, respectively). In post hoc analysis among patients initiating TDF, incidence rates of HBeAg seroclearance peaked at year 4 of TDF treatment (13.1/100 person-years), whereas a steep drop in HBsAg seroclearance incidence rates occurred after year 3 (at year 3 = 1.2/100 person-years versus thereafter = 0.6/100 person-years). CONCLUSION: HBsAg seroclearance and, to a lesser extent, HBeAg seroclearance remain difficult endpoints for patients coinfected with HIV-HBV to achieve. HBV-DNA suppression, associated with effective treatment, is strongly linked to seroclearance, but this mostly occurs within the first years of ART-containing highly potent anti-HBV activity.
OBJECTIVE: This study determines rates and risk factors associated with hepatitis B surface antigen (HBsAg) and hepatitis B 'e' antigen (HBeAg) seroclearance, two important prognostic indicators during infection with hepatitis B virus (HBV), in a large contemporary cohort of patients coinfected with HIV-HBV. DESIGN: Prospective cohort study of predominately antiretroviral therapy (ART) experienced, coinfected patients. METHODS:Participants enrolled in the French HIV-HBV Cohort had complete HBV serological battery conducted at inclusion and every yearly visit. Piecewise-exponential survival models were used to determine risk factors associated with seroclearance. RESULTS: A total of 290 patients, of whom 151 (52.1%) were HBeAg positive, had been followed for a median 7.4 years (interquartile range [IQR] = 3.1-8.0). Tenofovir (TDF) containing ART became increasingly more frequent, as rates of undetectable HBV-DNA increased accordingly (at baseline = 39.3%, end of follow-up = 91.0%). In HBeAg-positive patients, 60 of 151 had HBeAg seroclearance (cumulative 46.4% at end of follow-up) after a median 3.0 years (IQR = 2.0-4.9). Overall, 17 of 290 patients had HBsAg seroclearance (cumulative 7.4% at end of follow-up) after a median 4.6 years (IQR = 2.1-7.2). Lower levels of time-averaged cumulative HBV-DNA were significantly associated with both HBeAg and HBsAg seroclearance (P < 0.001 and P = 0.01, respectively). In post hoc analysis among patients initiating TDF, incidence rates of HBeAg seroclearance peaked at year 4 of TDF treatment (13.1/100 person-years), whereas a steep drop in HBsAg seroclearance incidence rates occurred after year 3 (at year 3 = 1.2/100 person-years versus thereafter = 0.6/100 person-years). CONCLUSION: HBsAg seroclearance and, to a lesser extent, HBeAg seroclearance remain difficult endpoints for patients coinfected with HIV-HBV to achieve. HBV-DNA suppression, associated with effective treatment, is strongly linked to seroclearance, but this mostly occurs within the first years of ART-containing highly potent anti-HBV activity.
Authors: Kasha P Singh; Megan Crane; Jennifer Audsley; Anchalee Avihingsanon; Joe Sasadeusz; Sharon R Lewin Journal: AIDS Date: 2017-09-24 Impact factor: 4.177
Authors: Lorin Begré; Charles Béguelin; Anders Boyd; Lars Peters; Jürgen Rockstroh; Huldrych F Günthard; Enos Bernasconi; Matthias Cavassini; Karine Lacombe; Amanda Mocroft; Gilles Wandeler; Andri Rauch Journal: Front Med (Lausanne) Date: 2022-09-15
Authors: Mamta K Jain; Karen J Vigil; Paul Parisot; Gabriella Go; Trung Vu; Xilong Li; Laura Hansen; Barbara S Taylor Journal: Open Forum Infect Dis Date: 2021-04-16 Impact factor: 3.835