Wan-Chen Tsai1, Wei-Ting Hsu1, Wang-Da Liu1, Hsin-Yun Sun1, Yu-Chung Chuang1, Yu-Shan Huang1,2, Aristine Cheng1, Kuan-Yin Lin3, Yi-Chia Huang2, Guan-Jhou Chen4, Sung-Hsi Huang2,5, Wang-Huei Sheng1, Szu-Min Hsieh1, Chien-Ching Hung1,5,6,7, Shan-Chwen Chang1. 1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University Hospital, Taipei, Taiwan. 2. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan. 3. Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan. 4. Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan. 5. Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan. 6. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. 7. China Medical University, Taichung, Taiwan.
Abstract
BACKGROUND: Tenofovir disoproxil fumarate (TDF) is active against both HBV and HIV. Whether the introduction of TDF-containing combination antiretroviral therapy (cART) has improved the outcome of HIV/HBV-coinfected patients remains unclear in areas of higher HBV endemicity. METHODS: We retrospectively reviewed medical records of newly diagnosed antiretroviral-naïve HIV-infected patients between 2007 and 2015. Four groups of patients were defined, according to the HBV status and availability of TDF for HIV treatment in Taiwan in 2011. The primary outcome was all-cause mortality. RESULTS: During the 9-year study period, 1,723 HIV-infected patients were included, with a median age of 31 years and baseline CD4 count of 273 cells per μL. The HBV seroprevalence had declined from 18.1% (125/692) in the pre-TDF era to 10.1% (104/1031) in the post-TDF era. The respective mortality rate for HIV/HBV-coinfected and HIV-monoinfected patients in the pre-TDF era was 23.2 (95% CI, 12.5-43.1) and 9.6 (95% CI, 6.1-15.0) deaths per 1000 person-years of follow-up [PYFU], and the respective mortality rate in the post-TDF era was 15.7 (95% CI, 7.0-34.8) and 8.0 (95% CI, 5.5-11.6) deaths per 1000 PYFU. The adjusted hazard ratio for mortality in multivariate Cox proportional-hazards regression analysis among HIV/HBV-coinfected patients compared to HIV-monoinfected patients was 2.79 (95% CI, 1.25-6.22) in pre-TDF era and 1.11 (95% CI, 0.45-2.72) in post-TDF era. CONCLUSIONS: In this country of high HBV endemicity, the adverse impact of chronic HBV infection on the survival observed in the pre-TDF era has significantly diminished among HIV/HBV-coinfected patients compared to HIV-monoinfected patients in the era of TDF-containing cART.
BACKGROUND:Tenofovir disoproxil fumarate (TDF) is active against both HBV and HIV. Whether the introduction of TDF-containing combination antiretroviral therapy (cART) has improved the outcome of HIV/HBV-coinfectedpatients remains unclear in areas of higher HBV endemicity. METHODS: We retrospectively reviewed medical records of newly diagnosed antiretroviral-naïve HIV-infectedpatients between 2007 and 2015. Four groups of patients were defined, according to the HBV status and availability of TDF for HIV treatment in Taiwan in 2011. The primary outcome was all-cause mortality. RESULTS: During the 9-year study period, 1,723 HIV-infectedpatients were included, with a median age of 31 years and baseline CD4 count of 273 cells per μL. The HBV seroprevalence had declined from 18.1% (125/692) in the pre-TDF era to 10.1% (104/1031) in the post-TDF era. The respective mortality rate for HIV/HBV-coinfected and HIV-monoinfectedpatients in the pre-TDF era was 23.2 (95% CI, 12.5-43.1) and 9.6 (95% CI, 6.1-15.0) deaths per 1000 person-years of follow-up [PYFU], and the respective mortality rate in the post-TDF era was 15.7 (95% CI, 7.0-34.8) and 8.0 (95% CI, 5.5-11.6) deaths per 1000 PYFU. The adjusted hazard ratio for mortality in multivariate Cox proportional-hazards regression analysis among HIV/HBV-coinfectedpatients compared to HIV-monoinfectedpatients was 2.79 (95% CI, 1.25-6.22) in pre-TDF era and 1.11 (95% CI, 0.45-2.72) in post-TDF era. CONCLUSIONS: In this country of high HBV endemicity, the adverse impact of chronic HBV infection on the survival observed in the pre-TDF era has significantly diminished among HIV/HBV-coinfectedpatients compared to HIV-monoinfectedpatients in the era of TDF-containing cART.
Authors: Rimke Bijker; Sasisopin Kiertiburanakul; Nagalingeswaran Kumarasamy; Sanjay Pujari; Ly P Sun; Oon T Ng; Man P Lee; Jun Y Choi; Kinh V Nguyen; Yu J Chan; Tuti P Merati; Do D Cuong; Jeremy Ross; Awachana Jiamsakul Journal: Antivir Ther Date: 2020
Authors: Berend J van Welzen; Colette Smit; Anders Boyd; Faydra I Lieveld; Tania Mudrikova; Peter Reiss; Annemarie E Brouwer; Andy I M Hoepelman; Joop E Arends Journal: Open Forum Infect Dis Date: 2020-06-25 Impact factor: 3.835