在替诺福韦治疗HIV/乙型肝炎病毒合并感染者期间,频繁的乙型肝炎表面抗原(HBsAg)清除。

IF 2.8 3区 医学 Q2 INFECTIOUS DISEASES
HIV Medicine Pub Date : 2025-02-25 DOI:10.1111/hiv.13766
Charles Béguelin, Bernard Surial, Eveline Hofmann, Lorin Begré, Aline Munting, Huldrych F. Günthard, Marcel Stöckle, Enos Bernasconi, Patrick Schmid, Alexandra Calmy, Franziska Suter-Riniker, Andri Rauch, Gilles Wandeler, the Swiss HIV Cohort Study (SHCS)
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引用次数: 0

摘要

乙型肝炎表面抗原(HBsAg)丢失在乙型肝炎病毒(HBV)单感染人群中是一种罕见的事件,但在HIV (PWH)人群中似乎发生得更频繁。我们评估了长期替诺福韦治疗期间发生HBsAg丢失的PWH/HBV合并感染的比例,并评估了其与替诺福韦开始时定量HBsAg (qHBsAg)水平的关系。方法:所有瑞士HIV队列研究的参与者均有两次或两次以上HBsAg检测阳性,间隔超过6个月,并且至少接受了4年的含替诺福韦抗逆转录病毒治疗(ART)。我们的主要结果是在替诺福韦治疗的前2年以及直到最后一次随访期间HBsAg的损失。我们利用多变量逻辑回归分析了替诺福韦治疗开始时qHBsAg水平与HBsAg损失之间的关系,并对潜在混杂因素进行了校正。结果:共纳入272例PWH合并HBV感染病例。中位年龄41岁(IQR 36-46), 81%(221)为男性。在替诺福韦开始治疗时,62%(169/272)接受过HBV积极治疗,49%(110/224)为乙型肝炎e抗原(HBeAg)阳性,82%(222/272)检测到HBV DNA(中位数4.0 log10 IU/mL, IQR 2.1-7.5), 19% (46/242) qHBsAg低。结论:我们发现长期含替诺福韦抗逆转录病毒治疗的PWH和HBV合并感染患者HBsAg损失率高,其中大多数人在替诺福韦开始治疗时qHBsAg低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Frequent hepatitis B surface antigen (HBsAg) clearance during tenofovir therapy in persons with HIV/hepatitis B virus coinfection

Introduction

Hepatitis B surface antigen (HBsAg) loss is a rare event among persons with hepatitis B virus (HBV) monoinfection but seems to happen more frequently in people with HIV (PWH). We assessed the proportion of PWH/HBV coinfection who experienced HBsAg loss during long-term tenofovir-therapy and evaluated its association with quantitative HBsAg (qHBsAg) levels at tenofovir start.

Methods

All Swiss HIV Cohort Study participants with two or more positive HBsAg measurements more than 6 months apart, and at least 4 years of tenofovir-containing antiretroviral therapy (ART), were considered. Our main outcomes were the loss of HBsAg during the first 2 years of tenofovir therapy and until the last available follow-up. We explored the association between qHBsAg levels at tenofovir start and HBsAg loss using multivariable logistic regression adjusted for potential confounders.

Results

A total of 272 PWH and HBV coinfection were included. Median age was 41 years (IQR 36–46) and 81% (221) were men. At tenofovir start, 62% (169/272) received prior HBV active therapy, 49% (110/224) were hepatitis B e antigen (HBeAg)-positive, 82% (222/272) had detectable HBV DNA (median 4.0 log10 IU/mL, IQR 2.1–7.5) and 19% (46/242) had low qHBsAg, defined as <1000 IU/mL. HBsAg loss was observed in 7% (19/272) of participants during the first 2 years of tenofovir-containing ART and in 16% (43/272) after a median follow-up time of 8.4 years (IQR 2.6–15.8). At the last follow-up, 59% (16/27) of those with HBsAg loss had seroconverted for detectable anti-HBs antibodies. In multivariable analyses, low qHBsAg at tenofovir start (OR 5.3, 95% CI 1.6–17.8) was a significant predictor of HBsAg loss.

Conclusion

We found high rates of HBsAg loss in PWH and HBV coinfection on long-term tenofovir-containing ART, most of whom had low qHBsAg at tenofovir start.

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来源期刊
HIV Medicine
HIV Medicine 医学-传染病学
CiteScore
5.10
自引率
10.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
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