Luca Mezzadri, Alessandro Guido Soria, Alice Ranzani, Sergio Malandrin, Francesca Sabbatini, Silvia Limonta, Anna Cappelletti, Elisa Colella, Nicola Squillace, Ilaria Chiara Giuseppina Caramma, Bianca Monti, Alban Rugova, Annalisa Cavallero, Paolo Bonfanti, Giuseppe Lapadula
{"title":"乙型肝炎核心抗体阳性与转氨酶升高的风险不相关后切换到双重抗逆转录病毒治疗。","authors":"Luca Mezzadri, Alessandro Guido Soria, Alice Ranzani, Sergio Malandrin, Francesca Sabbatini, Silvia Limonta, Anna Cappelletti, Elisa Colella, Nicola Squillace, Ilaria Chiara Giuseppina Caramma, Bianca Monti, Alban Rugova, Annalisa Cavallero, Paolo Bonfanti, Giuseppe Lapadula","doi":"10.1097/QAD.0000000000004227","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether hepatitis B core antibodies, indicative of possible occult hepatitis B virus (HBV) infection (pOBI), are associated with an increased risk of transaminase elevation in people with HIV (PWH) switching to two-drug regimens (2DR).</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Methods: </strong>We included PWH who switched to 2DR since 2018, if they discontinued at least one anti-HBV drug and were HBsAg-negative at baseline. Two cohorts were analyzed: cohort 1 discontinued tenofovir (TFV) but continued lamivudine (3TC), Cohort 2 switched to regimens without HBV-active drugs. Survival analysis, including Cox regression adjusting for potential confounders, was conducted to compare time to grade ≥1 transaminase increase in those with and without pOBI.</p><p><strong>Results: </strong>Among 167 patients in cohort 1 (35.2% with pOBI), the rate of transaminitis was 4.59 vs. 7.47 per 100 person-years for those with and without pOBI [incidence rate ratio (IRR) 0.61; 95% confidence interval (CI) 0.17-1.83; P = 0.259]. Cox multivariable analysis found no significant association between pOBI and transaminitis (hazard ratio 0.56; 95% CI 0.2-1.5; P = 0.266), with adjusted models confirming these results. Among 118 individuals in cohort 2 (33.9% with pOBI), transaminitis rates were 8.04 vs. 8.68 per 100 person-years for those with and without pOBI (IRR 0.93; 95% CI 0.19-3.91; P = 0.763). Cox regression showed no significant association between pOBI and transaminitis (hazard ratio 1.18; 95% CI 0.4-3.6; P = 0.769), with consistent findings in adjusted models. No HBV reactivation occurred in either cohort.</p><p><strong>Conclusion: </strong>pOBI was not associated with risk of transaminase elevation in PWH switching to dual therapies lacking anti-HBV agents.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1344-1352"},"PeriodicalIF":3.1000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262124/pdf/","citationCount":"0","resultStr":"{\"title\":\"Hepatitis B core antibody positivity is not associated with risk of transaminase elevation following switch to dual antiretroviral therapy.\",\"authors\":\"Luca Mezzadri, Alessandro Guido Soria, Alice Ranzani, Sergio Malandrin, Francesca Sabbatini, Silvia Limonta, Anna Cappelletti, Elisa Colella, Nicola Squillace, Ilaria Chiara Giuseppina Caramma, Bianca Monti, Alban Rugova, Annalisa Cavallero, Paolo Bonfanti, Giuseppe Lapadula\",\"doi\":\"10.1097/QAD.0000000000004227\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate whether hepatitis B core antibodies, indicative of possible occult hepatitis B virus (HBV) infection (pOBI), are associated with an increased risk of transaminase elevation in people with HIV (PWH) switching to two-drug regimens (2DR).</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Methods: </strong>We included PWH who switched to 2DR since 2018, if they discontinued at least one anti-HBV drug and were HBsAg-negative at baseline. Two cohorts were analyzed: cohort 1 discontinued tenofovir (TFV) but continued lamivudine (3TC), Cohort 2 switched to regimens without HBV-active drugs. Survival analysis, including Cox regression adjusting for potential confounders, was conducted to compare time to grade ≥1 transaminase increase in those with and without pOBI.</p><p><strong>Results: </strong>Among 167 patients in cohort 1 (35.2% with pOBI), the rate of transaminitis was 4.59 vs. 7.47 per 100 person-years for those with and without pOBI [incidence rate ratio (IRR) 0.61; 95% confidence interval (CI) 0.17-1.83; P = 0.259]. Cox multivariable analysis found no significant association between pOBI and transaminitis (hazard ratio 0.56; 95% CI 0.2-1.5; P = 0.266), with adjusted models confirming these results. Among 118 individuals in cohort 2 (33.9% with pOBI), transaminitis rates were 8.04 vs. 8.68 per 100 person-years for those with and without pOBI (IRR 0.93; 95% CI 0.19-3.91; P = 0.763). Cox regression showed no significant association between pOBI and transaminitis (hazard ratio 1.18; 95% CI 0.4-3.6; P = 0.769), with consistent findings in adjusted models. No HBV reactivation occurred in either cohort.</p><p><strong>Conclusion: </strong>pOBI was not associated with risk of transaminase elevation in PWH switching to dual therapies lacking anti-HBV agents.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"1344-1352\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262124/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004227\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004227","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估乙型肝炎核心抗体是否与转入双药方案（2DR）的HIV感染者（PWH）转氨酶升高的风险增加有关，乙肝核心抗体可能是隐性乙型肝炎病毒（HBV）感染（pOBI）的指示物。设计：队列研究。方法：我们纳入了自2018年以来改用2DR的PWH，如果他们停止使用至少一种抗hbv药物并且在基线时hbsag阴性。对两个队列进行分析：队列1停用替诺福韦（TFV），但继续使用拉米夫定（3TC），队列2切换到不使用hbv活性药物的方案。进行生存分析，包括对潜在混杂因素进行Cox回归调整，比较pOBI患者和非pOBI患者转氨酶升高≥1级的时间。结果：在队列1的167例患者中（35.2%患有pOBI），有和没有pOBI的患者的转氨炎发生率为4.59 vs. 7.47 / 100人年[发病率比（IRR） 0.61；95%置信区间（CI） 0.17-1.83；p = 0.259]。Cox多变量分析发现pOBI与转氨炎无显著相关性(风险比0.56；95% ci 0.2-1.5；P = 0.266)，调整后的模型证实了这些结果。在队列2的118名个体中（33.9%患有pOBI），有和没有pOBI的转氨炎发生率分别为8.04 vs 8.68 / 100人年(IRR 0.93；95% ci 0.19-3.91；p = 0.763)。Cox回归显示pOBI与转氨炎无显著相关性(风险比1.18；95% ci 0.4-3.6；P = 0.769)，调整后的模型结果一致。两组均未发生HBV再激活。结论：pOBI与PWH改用缺乏抗hbv药物的双重治疗的转氨酶升高风险无关。
Hepatitis B core antibody positivity is not associated with risk of transaminase elevation following switch to dual antiretroviral therapy.
Objective: To evaluate whether hepatitis B core antibodies, indicative of possible occult hepatitis B virus (HBV) infection (pOBI), are associated with an increased risk of transaminase elevation in people with HIV (PWH) switching to two-drug regimens (2DR).
Design: Cohort study.
Methods: We included PWH who switched to 2DR since 2018, if they discontinued at least one anti-HBV drug and were HBsAg-negative at baseline. Two cohorts were analyzed: cohort 1 discontinued tenofovir (TFV) but continued lamivudine (3TC), Cohort 2 switched to regimens without HBV-active drugs. Survival analysis, including Cox regression adjusting for potential confounders, was conducted to compare time to grade ≥1 transaminase increase in those with and without pOBI.
Results: Among 167 patients in cohort 1 (35.2% with pOBI), the rate of transaminitis was 4.59 vs. 7.47 per 100 person-years for those with and without pOBI [incidence rate ratio (IRR) 0.61; 95% confidence interval (CI) 0.17-1.83; P = 0.259]. Cox multivariable analysis found no significant association between pOBI and transaminitis (hazard ratio 0.56; 95% CI 0.2-1.5; P = 0.266), with adjusted models confirming these results. Among 118 individuals in cohort 2 (33.9% with pOBI), transaminitis rates were 8.04 vs. 8.68 per 100 person-years for those with and without pOBI (IRR 0.93; 95% CI 0.19-3.91; P = 0.763). Cox regression showed no significant association between pOBI and transaminitis (hazard ratio 1.18; 95% CI 0.4-3.6; P = 0.769), with consistent findings in adjusted models. No HBV reactivation occurred in either cohort.
Conclusion: pOBI was not associated with risk of transaminase elevation in PWH switching to dual therapies lacking anti-HBV agents.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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