We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Long-term Hepatitis B and Liver Outcomes Among Adults Taking Tenofovir-Containing Antiretroviral Therapy for HBV/HIV Coinfection in Zambia.
- Authors
Vinikoor, Michael J; Hamusonde, Kalongo; Muula, Guy; Asombang, Mah; Riebensahm, Carlotta; Chitundu, Helen; Sunkuntu-Sichizya, Veronica; Bhattacharya, Debika; Sinkala, Edford; Lauer, Georg; Chung, Raymond; Mbewe, Wilson; Egger, Matthias; Bosomprah, Samuel; Wandeler, Gilles
- Abstract
Background Long-term outcomes of tenofovir-containing antiretroviral therapy (ART) for hepatitis B virus (HBV)/human immunodeficiency virus (HIV) coinfection were evaluated in Zambia. Methods A prospective cohort of adults with HIV and hepatitis B surface antigen (HBsAg)-positivity was enrolled at ART initiation. On tenofovir-containing ART, we ascertained HBV viral load (VL) non-suppression, alanine aminotransferase (ALT) elevation, serologic end-points, progression of liver fibrosis based on elastography, and hepatocellular carcinoma (HCC) incidence. We also described a subgroup (low HBV VL and no/minimal fibrosis at baseline) that, under current international guidelines, would not have been treated in the absence of their HIV infection. Results Among 289 participants at ART start, median age was 34 years, 40.1% were women, median CD4 count was 191 cells/mm3, 44.2% were hepatitis B e antigen-positive, and 28.4% had liver fibrosis/cirrhosis. Over median 5.91 years of ART, 13.6% developed HBV viral non-suppression, which was associated with advanced HIV disease. ALT elevation on ART was linked with HBV VL non-suppression. Regression of fibrosis and cirrhosis were common, progression to cirrhosis was absent, and no cases of HCC were ascertained. HBsAg seroclearance was 9.4% at 2 and 15.4% at 5 years, with higher rates among patients with low baseline HBV replication markers. Conclusions Reassuring long-term liver outcomes were ascertained during tenofovir-based ART for HBV/HIV coinfection in Zambia. Higher than expected HBsAg seroclearance during ART underscores the need to include people with HIV in HBV cure research.
- Subjects
ZAMBIA; LIVER physiology; MEDICAL protocols; ANTIRETROVIRAL agents; VIRAL load; CIRRHOSIS of the liver; RESEARCH funding; TENOFOVIR; LOGISTIC regression analysis; TREATMENT effectiveness; HIV infections; MULTIVARIATE analysis; CHI-squared test; DESCRIPTIVE statistics; LONGITUDINAL method; FIBROSIS; HEPATITIS B; ALANINE aminotransferase; MIXED infections; DISEASE progression; HEPATOCELLULAR carcinoma; REGRESSION analysis; PROPORTIONAL hazards models
- Publication
Clinical Infectious Diseases, 2024, Vol 78, Issue 6, p1583
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad654