1. A Prospective Cohort Study of Novel Markers of Hepatitis B Virus Replication in Human Immunodeficiency Virus Coinfection
- Author
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Chung, Raymond T, King, Wendy C, Ghany, Marc G, Lisker-Melman, Mauricio, Hinerman, Amanda S, Khalili, Mandana, Sulkowski, Mark, Jain, Mamta K, Choi, Eun-Young K, Nalesnik, Michael A, Bhan, Atul K, Cloherty, Gavin, Wong, David K, Sterling, Richard K, and Network, HBV-HIV Cohort Study of the Hepatitis B Research
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Hepatitis - B ,Liver Disease ,Chronic Liver Disease and Cirrhosis ,Clinical Research ,Hepatitis ,Genetics ,Sexually Transmitted Infections ,Infectious Diseases ,HIV/AIDS ,4.1 Discovery and preclinical testing of markers and technologies ,6.1 Pharmaceuticals ,Infection ,Good Health and Well Being ,Adult ,Humans ,Middle Aged ,Antiviral Agents ,Biomarkers ,Coinfection ,DNA ,Viral ,Hepatitis B Core Antigens ,Hepatitis B e Antigens ,Hepatitis B Surface Antigens ,Hepatitis B virus ,Hepatitis B ,Chronic ,HIV Infections ,Prospective Studies ,Virus Replication ,RNA ,Viral ,HBcrAg ,HBV ,HBV RNA ,HIV ,Serum Biomarkers ,HBV-HIV Cohort Study of the Hepatitis B Research Network ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
Background & aimsThe contribution of the novel biomarkers, hepatitis B virus (HBV) RNA and HBV core-related antigen (HBcrAg), to characterization of HBV-human immunodeficiency virus (HIV) coinfection is unclear. We evaluated the longitudinal dynamics of HBV RNA and HBcrAg and their association with classical HBV serum biomarkers and liver histology and viral staining.MethodsHBV-HIV co-infected adults from 8 North American centers entered a National Institutes of Health-funded prospective cohort study. Demographic, clinical, serological, and virological data were collected at entry and every 24 to 48 weeks for up to 192 weeks. Participants with HBV RNA and HBcrAg measured ≥2 times (N = 95) were evaluated; 56 had paired liver biopsies obtained at study entry and end of follow-up.ResultsParticipants had a median age of 50 years; 97% were on combination anti-viral therapy. In hepatitis B e antigen (HBeAg)+ participants, there were significant declines in HBV RNA and HBcrAg over 192 weeks that tracked with declines in HBeAg, hepatitis B surface antigen, HBV DNA, and hepatitis B core antigen (HBcAg) hepatocyte staining grade (all P < .05). In HBeAg- participants, there were not significant declines in HBV RNA (P = .49) and HBcrAg (P = .63), despite modest reductions in hepatitis B surface antigen (P < .01) and HBV DNA (P = .03). HBV serum biomarkers were not significantly related to change in hepatic activity index, Ishak fibrosis score, or hepatocyte HBcAg loss (all P > .05).ConclusionsIn HBV-HIV coinfected adults on suppressive dually active antiviral therapy, the use of novel HBV markers reveals continued improvement in suppression of HBV transcription and translation over time. The lack of further improvement in HBV serum biomarkers among HBeAg- patients suggests limits to the benefit of combination anti-viral therapy and provide rationale for additional agents with distinct mechanisms of action.
- Published
- 2023