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Longer duration of HBV-active antiretroviral therapy is linked to favorable virological outcome in HIV-HBV co-infected patients.
- Source :
-
HIV clinical trials [HIV Clin Trials] 2009 May-Jun; Vol. 10 (3), pp. 153-9. - Publication Year :
- 2009
-
Abstract
- Background: HBV-HIV co-infection is associated with increased liver-related morbidity and mortality. Herein we analyzed HBV-related virologic and clinical outcomes in HBV-HIV patients in the HAART era.<br />Methods: HBsAg positive HIV-infected patients followed at a US academic center between 1990 and 2008 were assessed in a retrospective and longitudinal study. Factors associated with HBsAg and/or HBeAg clearance and with advanced liver disease were evaluated using logistic regression.<br />Results: 72 patients were evaluated. Their median time of follow-up and of adherence to HBV-active HAART were 3 and 1 years, respectively. HBeAg and HBsAg cleared in 17.6% and 5.5% of patients, respectively. More prolonged use of HBV-active HAART predicted clearance of HBeAg (odds ratio [OR] 2.66, 95% CI 1.15-6.16, p = .02) and of HBsAg (OR 1.54, 95% CI 1.02-2.31, p = .04). Patients clearing HBsAg tended to have higher baseline CD4 (mean CD4 counts: 550 vs. 246 cells/mm3; p = .06). Rate of diagnosis of liver-related complications and death were 24.6/1,000 and 10.5/1,000 patient-years, respectively. Higher ALT levels before HAART initiation were associated with the diagnosis of cirrhosis during follow-up (OR 1.02, 95% CI 1.002-1.03, p = .02).<br />Conclusions: Prolonged use of HBV-active HAART favors HBsAg and HBeAg clearance in HIV-HBV co-infected patients. Those with higher ALT levels at presentation have higher risk of being diagnosed with cirrhosis during the first few years of follow-up.
- Subjects :
- Academic Medical Centers
Adult
Black or African American
CD4 Lymphocyte Count
Female
HIV Infections complications
HIV Infections epidemiology
Hepatitis B complications
Hepatitis B epidemiology
Hepatitis B Surface Antigens blood
Hepatitis B e Antigens blood
Hepatitis B virus drug effects
Hepatitis B virus immunology
Hepatitis C complications
Humans
Liver Cirrhosis epidemiology
Liver Cirrhosis etiology
Logistic Models
Longitudinal Studies
Male
Middle Aged
North Carolina epidemiology
Prognosis
Retrospective Studies
Risk Factors
Treatment Outcome
Anti-Retroviral Agents therapeutic use
Antiretroviral Therapy, Highly Active
HIV Infections drug therapy
Hepatitis B drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1528-4336
- Volume :
- 10
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- HIV clinical trials
- Publication Type :
- Academic Journal
- Accession number :
- 19632954
- Full Text :
- https://doi.org/10.1310/hct1003-153