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. 2014 Jun 1;66(2):172-80.
doi: 10.1097/QAI.0000000000000149.

Virologic and serologic outcomes of mono versus dual HBV therapy and characterization of HIV/HBV coinfection in a US cohort

Minhee Kang  1 , Kimberly Hollabaugh, Vinh Pham, Susan L Koletar, Kunling Wu, Marlene Smurzynski, Judith A Aberg
Affiliations

Virologic and serologic outcomes of mono versus dual HBV therapy and characterization of HIV/HBV coinfection in a US cohort

Minhee Kang et al. J Acquir Immune Defic Syndr. .

Abstract

Objectives: To characterize HIV/hepatitis B virus (HBV) coinfection in the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort and compare long-term HBV outcomes between regimens with 1 (MONO) or 2 (DUAL) anti-HBV agents.

Design: A retrospective study of coinfected AIDS Clinical Trials Group Longitudinal Linked Randomized Trials subjects who received regimens containing anti-HBV agent(s).

Methods: Stored samples at baseline and weeks 16, 32, 48, 144, and 240 were tested for HBV DNA, HBV e antigen (HBeAg), HBV e antibody (HBeAb), and hepatitis D virus (HDV) antibody. Resistance and genotype were tested in samples with HBV DNA >600 IU/mL. MONO versus DUAL analyses were limited to HBV treatment-naive subjects (Naive-MONO, Naive-DUAL).

Results: Of 150 study subjects, median age was 40 years, 96% were male; 57% white, 26% black, 13% Hispanic. Baseline median CD4 was 224 cells per cubic millimeter, HIV RNA 4.48 log10 copies/mL, HBV DNA 6.30 log10 IU/mL; 59% HBeAg positive and 65% HBeAb negative; HBV genotypes A = 69%, G = 18%, D = 7%, <2% for A/G, B, C, F, H. Coinfection with HDV was 2%. There were 49 Naive-MONO (lamivudine) and 22 Naive-DUAL (11 lamivudine + tenofovir, 11 emtricitabine + tenofovir) with detectable HBV DNA. In the 240-week follow-up, HBV DNA suppression was not significantly higher in Naive-DUAL (P = 0.14); lower baseline HBV DNA (P < 0.01) was associated with suppression. Among 32 Naive-MONO subjects with detectable HBV DNA at baseline and results at week 48, 41% suppressed; among such 15 Naive-DUAL subjects, 53% suppressed. HBeAg and HBeAb analyses showed similar trends.

Conclusions: While consistent trends toward increased HBV DNA suppression, HBeAg loss and HBeAb seroconversion were observed in Naive-DUAL compared with Naive-MONO, they were not statistically significant. Overall, HDV coinfection was low.

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Conflict of interest statement

Conflicts: Dr. Aberg serves on AbbVie, Janssen and Merck scientific advisory boards; Dr. Aberg has moved affiliation to the ICAHN School of Medicine at Mount Sinai.

Figures

Figure 1
Figure 1
Baseline mutations detected in subjects with HBV DNA > 600 IU/mL * Note that one subject may have more than one mutation.
Figure 2
Figure 2
Naïve-MONO vs. Naïve-DUAL outcomes: (A) HBV DNA suppression, (B) HBeAg Loss, and (C) HBeAb development
Figure 3
Figure 3
Proportions of subjects with HIV RNA > LLQ and CD4+ T-cell count quartiles at study visits in (A) HBV treatment-naïve and (B) HBV treatment-experienced
See this image and copyright information in PMC

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