Predictors of HBeAg status and hepatitis B viraemia in HIV-infected patients with chronic hepatitis B in the HAART era in Brazil

September 27, 2011

Predictors of HBeAg status and hepatitis B viraemia in HIV-infected patients

with chronic hepatitis B in the HAART era in Brazil Cassia Mendes-Correa ,

Joao RR Pinho , Michele S Gomes-Gouvea , C DA Silva , Cristina F

Guastini , Luiz G s , G Leite , Mariliza H Silva , Reinaldo J

Gianini and E Uip BMC Infectious Diseases 2011,

11:247doi:10.1186/1471-2334-11-247Published:20 September 2011Abstract

(provisional)BackgroundHBV-HIV co-infection is associated with an increased

liver-related morbidity and mortality. However, little is known about the

natural history of chronic hepatitis B in HIV-infected individuals under highly

active antiretroviral therapy (HAART) receiving at least one of the two drugs

that also affect HBV (TDF and LAM). Information about HBeAg status and HBV

viremia in HIV/HBV co-infected patients is scarce. The objective of this study

was to search for clinical and virological variables associated with HBeAg

status and HBV viremia in patients of an HIV/HBV co-infected cohort. MethodsA

retrospective cross-sectional study was performed, of HBsAg-positive

HIV-infected patients in treatment between 1994 and 2007 in two AIDS outpatient

clinics located in the Sao o metropolitan area, Brazil. The baseline data

were age, sex, CD4 T+ cell count, ALT level, HIV and HBV viral load, HBV

genotype, and duration of antiretroviral use. The variables associated to HBeAg

status and HBV viremia were assessed using logistic regression. ResultsA total

of 86 HBsAg patients were included in the study. Of these, 48 (56%) were using

combination therapy that included lamivudine (LAM) and tenofovir (TDF), 31 (36%)

were using LAM monotherapy, and 7 patients had no previous use of either one.

Duration of use of TDF and LAM varied from 4 to 21 and 7 to 144 months,

respectively. A total of 42 (48.9%) patients were HBeAg positive and 44 (51.1%)

were HBeAg negative. The multivariate analysis revealed that the use of TDF for

longer than 12 months was associated with undetectable HBV DNA viral load (serum

HBV DNA level < 60UI/ml) (p = 0.047). HBeAg positivity was associated with HBV

DNA > 60 UI/ml (p = 0.001) and ALT levels above normality (p = 0.038).

ConclusionProlonged use of TDF containing HAART is associated with undetectable

HBV DNA viral load. HBeAg positivity is associated with HBV viremia and

increased ALT levels. The complete article is available as a provisional PDF.

The fully formatted PDF and HTML versions are in production.

September 27, 2011