K Velen1, S Charalambous1,2, C Innes1, G J Churchyard1,2, C J Hoffmann1,3,2. 1. The Aurum Institute, Johannesburg, South Africa. 2. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. 3. Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
OBJECTIVES: To assess the effect of chronic hepatitis B on survival and clinical complexity among people living with HIV following antiretroviral therapy (ART) initiation. METHODS: We evaluated mortality and single-drug substitutions up to 3 years from ART initiation (median follow-up 2.75 years; interquartile range 2-3 years) among patients with and without chronic hepatitis B (CHB) enrolled in a workplace HIV care programme in South Africa. RESULTS: Mortality was increased for CHB patients with hepatitis B virus (HBV) DNA levels > 10 000 copies/mL (adjusted hazard ratio 3.1; 95% confidence interval 1.2-8.0) compared with non-CHB patients. We did not observe a similar difference between non-CHB patients and those with CHB and HBV DNA < 10 000 copies/mL (adjusted hazard ratio 0.70; 95% confidence interval 0.2-2.3). Single-drug substitutions occurred more frequently among coinfected patients regardless of HBV DNA level. CONCLUSIONS: Our findings suggest that CHB may increase mortality and complicate ART management.
OBJECTIVES: To assess the effect of chronic hepatitis B on survival and clinical complexity among people living with HIV following antiretroviral therapy (ART) initiation. METHODS: We evaluated mortality and single-drug substitutions up to 3 years from ART initiation (median follow-up 2.75 years; interquartile range 2-3 years) among patients with and without chronic hepatitis B (CHB) enrolled in a workplace HIV care programme in South Africa. RESULTS: Mortality was increased for CHB patients with hepatitis B virus (HBV) DNA levels > 10 000 copies/mL (adjusted hazard ratio 3.1; 95% confidence interval 1.2-8.0) compared with non-CHBpatients. We did not observe a similar difference between non-CHBpatients and those with CHB and HBV DNA < 10 000 copies/mL (adjusted hazard ratio 0.70; 95% confidence interval 0.2-2.3). Single-drug substitutions occurred more frequently among coinfected patients regardless of HBV DNA level. CONCLUSIONS: Our findings suggest that CHB may increase mortality and complicate ART management.
Authors: H Nina Kim; Craig W Newcomb; Dena M Carbonari; Jason A Roy; Jessie Torgersen; Keri N Althoff; Mari M Kitahata; K Rajender Reddy; Joseph K Lim; Michael J Silverberg; Angel M Mayor; Michael A Horberg; Edward R Cachay; Gregory D Kirk; Jing Sun; Mark Hull; M John Gill; Timothy R Sterling; Jay R Kostman; Marion G Peters; Richard D Moore; Marina B Klein; Vincent Lo Re Journal: Hepatology Date: 2021-06-22 Impact factor: 17.298