Characteristics, management and evolution of Hepatitis B in HIV infected patient

[Guest guest]

www.hbvadvocate.org

AASLD 2006

1318. Characteristics, management and evolution of Hepatitis B in HIV

infected patients: the prospective multicenter EPIB05 survey.

L. Piroth; D. Sene; I. Goderel; P. Stanislas; K. Lacombe; D. Rey; V.

Loustaud-Ratti; J. Bergmann; G. Pialoux; A. Gervais; C. Lascoux-Combe; F.

Carrat; P. Cacoub.

Methods:

A questionnaire itemizing the characteristics of HBV infection, and their

evolution over time according to the different HBV treatments taken, was

sent to the participating French Internal Medicine, Infectious Diseases and

Hepatology Departments in 89 hospitals (GERMIVIC). A total of 479 patients

(pts) with past or present chronic HBV infection (Ag HBs+) and seen during

the 4 week study period in October 2005 have been included.

Results:

Main characteristics : HIV co-infection was observed in 260 (55%) pts.

HIV-HBV co-infected (HIV+) compared to HBV mono-infected patients (HIV-)

were more frequently male (80 vs 68%, p=0.005), past or present IVDUs (10 vs

0.5%, p<10-3), alcoholics (11 vs 3 %, p=0.005), more often born in France

(56 vs 23%) than in sub-saharian Africa (32% vs 36%) or Asia (1.2 vs 21%)

(p<10-3). 62 (24%) pts developed AIDS defining event. 235 (94%) pts have

been on antiretroviral treatment [mean final CD4 count 433 +/- 349 (25.8 +/-

29%) and HIV viral load 2.43 +/- 1.21 log10 copies/ml].

HBV infection:

Before HBV treatment, HBe Ag+ and anti-HBe Ab+ were found in 103 (58%) and

68 (39 %) HIV+ pts (vs. 28% and 72% HIV- pts, p<10-3). Clinical presentation

of hepatitis B was similar.

Co-infections:

Compared to HIV- pts, HIV+ pts were more often HCV positive (13 vs. 3.8%,

p<10-3), whereas HDV infection was less frequent (4.7 vs. 7.1%, p<10-3),

even if less often investigated (79 vs 92%, p<10-3)

Liver histology: was assessed in 32 (12%) HIV+ pts before HBV treatment,

with a median METAVIR score of A1-F2 (vs. A2F1 for HIV- pts, p=NS). Liver

histology was assessed during follow up in 53 (20%) HIV+ pts (liver biopsy

46, biological tests 7).

HBV treatment was prescribed in 213 (82%) HIV+ pts (monotherapy 41.8%,

combinations 58.2%) vs. 73 (34.1%) HIV- pts (monotherapy 57.5%, combinations

42.5%) (p<10-3). HIV+ pts received lamivudine (76%), tenofovir (64%),

adefovir (10%), emtricitabine (7.5%), or pegylated interferon (1.4%).

Serological evolution: loss of HBe Ag and HBe seroconversion were less often

observed in HIV+ than HIV- pts (8.6 vs. 11.6% and 6.9 vs 13.8%, p=0.05 and

p=0.02). HBs Ag disappeared in 5 HIV+ pts (vs 3) and appeared in 4 (vs 0)

(p=0.03).

Conclusions:

During chronic HBV infection in HIV infected patients,

1) Infection with pre-core HBV mutants is less frequent than in

mono-infected

2) Specific management of HBV infection still needs to improve, even if

liver histological evaluations and specific anti-HBV treatments are

increasing

3) Anti-HBV combinations are more frequently used than in HIV- patients

4) Loss of HBe Ag or HBe seroconversion are still infrequent, underlying the

need for new drugs/strategies.

http://www.hbvadvocate.org/news/reports/HBV_AASLD_2006/HBV%20Abstracts/HBV%20abs\

tractsOct29.htm#HBV1318

_________________________________________________________________

All-in-one security and maintenance for your PC. Get a free 90-day trial!

http://clk.atdmt.com/MSN/go/msnnkwlo0050000002msn/direct/01/?href=http://www.win\

dowsonecare.com/?sc_cid=msn_hotmail

[Guest guest]

www.hbvadvocate.org

AASLD 2006

1318. Characteristics, management and evolution of Hepatitis B in HIV

infected patients: the prospective multicenter EPIB05 survey.

L. Piroth; D. Sene; I. Goderel; P. Stanislas; K. Lacombe; D. Rey; V.

Loustaud-Ratti; J. Bergmann; G. Pialoux; A. Gervais; C. Lascoux-Combe; F.

Carrat; P. Cacoub.

Methods:

A questionnaire itemizing the characteristics of HBV infection, and their

evolution over time according to the different HBV treatments taken, was

sent to the participating French Internal Medicine, Infectious Diseases and

Hepatology Departments in 89 hospitals (GERMIVIC). A total of 479 patients

(pts) with past or present chronic HBV infection (Ag HBs+) and seen during

the 4 week study period in October 2005 have been included.

Results:

Main characteristics : HIV co-infection was observed in 260 (55%) pts.

HIV-HBV co-infected (HIV+) compared to HBV mono-infected patients (HIV-)

were more frequently male (80 vs 68%, p=0.005), past or present IVDUs (10 vs

0.5%, p<10-3), alcoholics (11 vs 3 %, p=0.005), more often born in France

(56 vs 23%) than in sub-saharian Africa (32% vs 36%) or Asia (1.2 vs 21%)

(p<10-3). 62 (24%) pts developed AIDS defining event. 235 (94%) pts have

been on antiretroviral treatment [mean final CD4 count 433 +/- 349 (25.8 +/-

29%) and HIV viral load 2.43 +/- 1.21 log10 copies/ml].

HBV infection:

Before HBV treatment, HBe Ag+ and anti-HBe Ab+ were found in 103 (58%) and

68 (39 %) HIV+ pts (vs. 28% and 72% HIV- pts, p<10-3). Clinical presentation

of hepatitis B was similar.

Co-infections:

Compared to HIV- pts, HIV+ pts were more often HCV positive (13 vs. 3.8%,

p<10-3), whereas HDV infection was less frequent (4.7 vs. 7.1%, p<10-3),

even if less often investigated (79 vs 92%, p<10-3)

Liver histology: was assessed in 32 (12%) HIV+ pts before HBV treatment,

with a median METAVIR score of A1-F2 (vs. A2F1 for HIV- pts, p=NS). Liver

histology was assessed during follow up in 53 (20%) HIV+ pts (liver biopsy

46, biological tests 7).

HBV treatment was prescribed in 213 (82%) HIV+ pts (monotherapy 41.8%,

combinations 58.2%) vs. 73 (34.1%) HIV- pts (monotherapy 57.5%, combinations

42.5%) (p<10-3). HIV+ pts received lamivudine (76%), tenofovir (64%),

adefovir (10%), emtricitabine (7.5%), or pegylated interferon (1.4%).

Serological evolution: loss of HBe Ag and HBe seroconversion were less often

observed in HIV+ than HIV- pts (8.6 vs. 11.6% and 6.9 vs 13.8%, p=0.05 and

p=0.02). HBs Ag disappeared in 5 HIV+ pts (vs 3) and appeared in 4 (vs 0)

(p=0.03).

Conclusions:

During chronic HBV infection in HIV infected patients,

1) Infection with pre-core HBV mutants is less frequent than in

mono-infected

2) Specific management of HBV infection still needs to improve, even if

liver histological evaluations and specific anti-HBV treatments are

increasing

3) Anti-HBV combinations are more frequently used than in HIV- patients

4) Loss of HBe Ag or HBe seroconversion are still infrequent, underlying the

need for new drugs/strategies.

http://www.hbvadvocate.org/news/reports/HBV_AASLD_2006/HBV%20Abstracts/HBV%20abs\

tractsOct29.htm#HBV1318

_________________________________________________________________

All-in-one security and maintenance for your PC. Get a free 90-day trial!

http://clk.atdmt.com/MSN/go/msnnkwlo0050000002msn/direct/01/?href=http://www.win\

dowsonecare.com/?sc_cid=msn_hotmail

[Guest guest]

www.hbvadvocate.org

AASLD 2006

1318. Characteristics, management and evolution of Hepatitis B in HIV

infected patients: the prospective multicenter EPIB05 survey.

L. Piroth; D. Sene; I. Goderel; P. Stanislas; K. Lacombe; D. Rey; V.

Loustaud-Ratti; J. Bergmann; G. Pialoux; A. Gervais; C. Lascoux-Combe; F.

Carrat; P. Cacoub.

Methods:

A questionnaire itemizing the characteristics of HBV infection, and their

evolution over time according to the different HBV treatments taken, was

sent to the participating French Internal Medicine, Infectious Diseases and

Hepatology Departments in 89 hospitals (GERMIVIC). A total of 479 patients

(pts) with past or present chronic HBV infection (Ag HBs+) and seen during

the 4 week study period in October 2005 have been included.

Results:

Main characteristics : HIV co-infection was observed in 260 (55%) pts.

HIV-HBV co-infected (HIV+) compared to HBV mono-infected patients (HIV-)

were more frequently male (80 vs 68%, p=0.005), past or present IVDUs (10 vs

0.5%, p<10-3), alcoholics (11 vs 3 %, p=0.005), more often born in France

(56 vs 23%) than in sub-saharian Africa (32% vs 36%) or Asia (1.2 vs 21%)

(p<10-3). 62 (24%) pts developed AIDS defining event. 235 (94%) pts have

been on antiretroviral treatment [mean final CD4 count 433 +/- 349 (25.8 +/-

29%) and HIV viral load 2.43 +/- 1.21 log10 copies/ml].

HBV infection:

Before HBV treatment, HBe Ag+ and anti-HBe Ab+ were found in 103 (58%) and

68 (39 %) HIV+ pts (vs. 28% and 72% HIV- pts, p<10-3). Clinical presentation

of hepatitis B was similar.

Co-infections:

Compared to HIV- pts, HIV+ pts were more often HCV positive (13 vs. 3.8%,

p<10-3), whereas HDV infection was less frequent (4.7 vs. 7.1%, p<10-3),

even if less often investigated (79 vs 92%, p<10-3)

Liver histology: was assessed in 32 (12%) HIV+ pts before HBV treatment,

with a median METAVIR score of A1-F2 (vs. A2F1 for HIV- pts, p=NS). Liver

histology was assessed during follow up in 53 (20%) HIV+ pts (liver biopsy

46, biological tests 7).

HBV treatment was prescribed in 213 (82%) HIV+ pts (monotherapy 41.8%,

combinations 58.2%) vs. 73 (34.1%) HIV- pts (monotherapy 57.5%, combinations

42.5%) (p<10-3). HIV+ pts received lamivudine (76%), tenofovir (64%),

adefovir (10%), emtricitabine (7.5%), or pegylated interferon (1.4%).

Serological evolution: loss of HBe Ag and HBe seroconversion were less often

observed in HIV+ than HIV- pts (8.6 vs. 11.6% and 6.9 vs 13.8%, p=0.05 and

p=0.02). HBs Ag disappeared in 5 HIV+ pts (vs 3) and appeared in 4 (vs 0)

(p=0.03).

Conclusions:

During chronic HBV infection in HIV infected patients,

1) Infection with pre-core HBV mutants is less frequent than in

mono-infected

2) Specific management of HBV infection still needs to improve, even if

liver histological evaluations and specific anti-HBV treatments are

increasing

3) Anti-HBV combinations are more frequently used than in HIV- patients

4) Loss of HBe Ag or HBe seroconversion are still infrequent, underlying the

need for new drugs/strategies.

http://www.hbvadvocate.org/news/reports/HBV_AASLD_2006/HBV%20Abstracts/HBV%20abs\

tractsOct29.htm#HBV1318

_________________________________________________________________

All-in-one security and maintenance for your PC. Get a free 90-day trial!

http://clk.atdmt.com/MSN/go/msnnkwlo0050000002msn/direct/01/?href=http://www.win\

dowsonecare.com/?sc_cid=msn_hotmail

[Guest guest]

www.hbvadvocate.org

AASLD 2006

1318. Characteristics, management and evolution of Hepatitis B in HIV

infected patients: the prospective multicenter EPIB05 survey.

L. Piroth; D. Sene; I. Goderel; P. Stanislas; K. Lacombe; D. Rey; V.

Loustaud-Ratti; J. Bergmann; G. Pialoux; A. Gervais; C. Lascoux-Combe; F.

Carrat; P. Cacoub.

Methods:

A questionnaire itemizing the characteristics of HBV infection, and their

evolution over time according to the different HBV treatments taken, was

sent to the participating French Internal Medicine, Infectious Diseases and

Hepatology Departments in 89 hospitals (GERMIVIC). A total of 479 patients

(pts) with past or present chronic HBV infection (Ag HBs+) and seen during

the 4 week study period in October 2005 have been included.

Results:

Main characteristics : HIV co-infection was observed in 260 (55%) pts.

HIV-HBV co-infected (HIV+) compared to HBV mono-infected patients (HIV-)

were more frequently male (80 vs 68%, p=0.005), past or present IVDUs (10 vs

0.5%, p<10-3), alcoholics (11 vs 3 %, p=0.005), more often born in France

(56 vs 23%) than in sub-saharian Africa (32% vs 36%) or Asia (1.2 vs 21%)

(p<10-3). 62 (24%) pts developed AIDS defining event. 235 (94%) pts have

been on antiretroviral treatment [mean final CD4 count 433 +/- 349 (25.8 +/-

29%) and HIV viral load 2.43 +/- 1.21 log10 copies/ml].

HBV infection:

Before HBV treatment, HBe Ag+ and anti-HBe Ab+ were found in 103 (58%) and

68 (39 %) HIV+ pts (vs. 28% and 72% HIV- pts, p<10-3). Clinical presentation

of hepatitis B was similar.

Co-infections:

Compared to HIV- pts, HIV+ pts were more often HCV positive (13 vs. 3.8%,

p<10-3), whereas HDV infection was less frequent (4.7 vs. 7.1%, p<10-3),

even if less often investigated (79 vs 92%, p<10-3)

Liver histology: was assessed in 32 (12%) HIV+ pts before HBV treatment,

with a median METAVIR score of A1-F2 (vs. A2F1 for HIV- pts, p=NS). Liver

histology was assessed during follow up in 53 (20%) HIV+ pts (liver biopsy

46, biological tests 7).

HBV treatment was prescribed in 213 (82%) HIV+ pts (monotherapy 41.8%,

combinations 58.2%) vs. 73 (34.1%) HIV- pts (monotherapy 57.5%, combinations

42.5%) (p<10-3). HIV+ pts received lamivudine (76%), tenofovir (64%),

adefovir (10%), emtricitabine (7.5%), or pegylated interferon (1.4%).

Serological evolution: loss of HBe Ag and HBe seroconversion were less often

observed in HIV+ than HIV- pts (8.6 vs. 11.6% and 6.9 vs 13.8%, p=0.05 and

p=0.02). HBs Ag disappeared in 5 HIV+ pts (vs 3) and appeared in 4 (vs 0)

(p=0.03).

Conclusions:

During chronic HBV infection in HIV infected patients,

1) Infection with pre-core HBV mutants is less frequent than in

mono-infected

2) Specific management of HBV infection still needs to improve, even if

liver histological evaluations and specific anti-HBV treatments are

increasing

3) Anti-HBV combinations are more frequently used than in HIV- patients

4) Loss of HBe Ag or HBe seroconversion are still infrequent, underlying the

need for new drugs/strategies.

http://www.hbvadvocate.org/news/reports/HBV_AASLD_2006/HBV%20Abstracts/HBV%20abs\

tractsOct29.htm#HBV1318

_________________________________________________________________

All-in-one security and maintenance for your PC. Get a free 90-day trial!

http://clk.atdmt.com/MSN/go/msnnkwlo0050000002msn/direct/01/?href=http://www.win\

dowsonecare.com/?sc_cid=msn_hotmail