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- Title
Profiles of liver fibrosis evolution during long‐term tenofovir treatment in HIV‐positive patients coinfected with hepatitis B.
- Authors
Dezanet, Lorenza N. C.; Miailhes, Patrick; Lascoux‐Combe, Caroline; Chas, Julie; Maylin, Sarah; Gabassi, Audrey; Rougier, Hayette; Delaugerre, Constance; Lacombe, Karine; Boyd, Anders
- Abstract
Background & Aims: Data on liver fibrosis evolution and its involvement in liver‐related morbidity are scarce in individuals with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co‐infection during treatment. We identified profiles of liver fibrosis evolution in coinfected patients undergoing tenofovir (TDF). Methods: We included 169 HIV‐HBV‐coinfected patients on TDF‐based antiretroviral therapy. Virological and clinical data were obtained at TDF‐initiation and every 6‐12 months. From data on non‐invasive liver fibrosis assessments collected yearly (FibroTest®), we established clusters of individuals with similar liver fibrosis evolution using group‐based trajectory models. Results: Four profiles of liver fibrosis evolution were established from a median follow‐up of 7.6 years (IQR = 3.1‐13.1): low fibrosis with no progression (29.6%, profile A), low fibrosis with progression (22.5%, profile B), moderate fibrosis with high fluctuation (39.6%, profile C), and cirrhosis with no regression (8.3%, profile D). When compared to profile A, baseline HBeAg‐positive status was associated with profiles B (P =.007) and C (P =.004), older age with profiles C (P <.001) and D (P =.001), exposure to second‐generation protease inhibitors with profile C (P =.004), and CD4+ <500/mm3 at the last visit with profiles C (P =.02) and D (P =.002). Incident liver‐related events occurred in profiles other than A (B, n = 1/38; C, n = 6/67; D, n = 3/14) and all five cases of hepatocellular carcinoma occurred in profiles C (n = 2) and D (n = 3). Conclusions: TDF‐treated HIV‐HBV coinfected individuals do not seem to benefit from comparable levels of liver fibrosis regression as in HBV mono‐infection. Liver‐related morbidity occurs mainly in those with fluctuating or consistently high fibrosis levels.
- Subjects
FIBROSIS; MIXED infections; CHRONIC hepatitis B; HEPATITIS B; LONG-Term Evolution (Telecommunications); HIV-positive persons; HEPATITIS B virus
- Publication
Liver International, 2021, Vol 41, Issue 12, p2874
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.15019