. 2021 Jul 20;6(2):137-148.

doi: 10.3138/jammi-2020-0011. eCollection 2021 Jun.

Clinical and demographic predictors of antiretroviral efficacy in HIV-HBV co-infected patients

Urvi Rana^{1

2}, Matt Driedger³, Paul Sereda⁴, Shenyi Pan⁴, Erin Ding⁴, Alex Wong⁵, Sharon Walmsley⁶, Marina Klein⁷, Deborah Kelly⁸, Mona Loutfy⁹, Rejean Thomas¹⁰, Stephen Sanche¹¹, Abigail Kroch¹², Nima Machouf¹³, Marie-Héléne Roy-Gagnon¹, Robert Hogg^{4

14}, Curtis L Cooper^{1

3}

Affiliations

¹ School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
² College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States.
³ Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁴ BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
⁵ Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
⁶ University Health Network, Toronto, Ontario, Canada.
⁷ Research Institute of McGill University Health Centre, Montreal, Quebec, Canada.
⁸ Memorial University of Newfoundland, Saint John's, Newfoundland, Canada.
⁹ Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
¹⁰ Clinique Medicale l'Actuel, Montreal, Quebec, Canada.
¹¹ Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹² Ontario HIV Treatment Network, Toronto, Ontario, Canada.
¹³ Clinique de Médicine Urbaine du Quartier Latin, Montreal, Quebec, Canada.
¹⁴ Simon Fraser University, Burnaby, British Columbia, Canada.

PMID: 36341035
PMCID: PMC9608701
DOI: 10.3138/jammi-2020-0011

Clinical and demographic predictors of antiretroviral efficacy in HIV-HBV co-infected patients

Urvi Rana et al. J Assoc Med Microbiol Infect Dis Can. 2021.

. 2021 Jul 20;6(2):137-148.

doi: 10.3138/jammi-2020-0011. eCollection 2021 Jun.

Authors

Affiliations

¹ School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
² College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States.
³ Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁴ BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
⁵ Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
⁶ University Health Network, Toronto, Ontario, Canada.
⁷ Research Institute of McGill University Health Centre, Montreal, Quebec, Canada.
⁸ Memorial University of Newfoundland, Saint John's, Newfoundland, Canada.
⁹ Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
¹⁰ Clinique Medicale l'Actuel, Montreal, Quebec, Canada.
¹¹ Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹² Ontario HIV Treatment Network, Toronto, Ontario, Canada.
¹³ Clinique de Médicine Urbaine du Quartier Latin, Montreal, Quebec, Canada.
¹⁴ Simon Fraser University, Burnaby, British Columbia, Canada.

PMID: 36341035
PMCID: PMC9608701
DOI: 10.3138/jammi-2020-0011

Abstract
in English, French

Background: The clinical and demographic characteristics that predict antiretroviral efficacy among patients co-infected with HIV and hepatitis B virus (HBV) remain poorly defined. We evaluated HIV virological suppression and rebound in a cohort of HIV-HBV co-infected patients initiated on antiretroviral therapy.

Methods: A retrospective cohort analysis was performed with Canadian Observation Cohort Collaboration data. Cox proportional hazards models were used to determine the factors associated with time to virological suppression and time to virological rebound.

Results: HBV status was available for 2,419 participants. A total of 8% were HBV co-infected, of whom 95% achieved virological suppression. After virological suppression, 29% of HIV-HBV co-infected participants experienced HIV virological rebound. HBV co-infection itself did not predict virological suppression or rebound risk. The rate of virological suppression was lower among patients with a history of injection drug use or baseline CD4 cell counts of <199 cells per cubic millimetre. Low baseline HIV RNA and men-who-have-sex-with-men status were significantly associated with a higher rate of virological suppression. Injection drug use and non-White race predicted viral rebound.

Conclusions: HBV co-infected HIV patients achieve similar antiretroviral outcomes as those living with HIV mono-infection. Equitable treatment outcomes may be approached by targeting resources to key subpopulations living with HIV-HBV co-infection.

Historique: Les caractéristiques cliniques et démographiques prédictives de l’efficacité antirétrovirale chez les patients co-infectés par le virus de l’immunodéficience humaine (VIH) et le virus de l’hépatite B (VHB) demeurent mal définies. Les chercheurs ont évalué la suppression et le rebond virologiques du VIH dans une cohorte de patients co-infectés par le VIH et le VHB chez qui on avait entrepris un traitement antirétroviral.

Méthodologie: Les chercheurs ont réalisé une analyse rétrospective de cohorte à l’aide des données de la Canadian Observation Cohort Collaboration. Ils ont utilisé le modèle à risques proportionnels de Cox pour déterminer les facteurs associés à la période jusqu’à la suppression et au rebond virologiques.

Résultats: Les chercheurs ont obtenu le statut de VHB de 2 419 participants. Au total, 8 % étaient co-infectés par le VHB, dont 95 % présentaient une suppression virologique. Après la suppression virologique, 29 % des participants co-infectés par le VIH et le VHB ont subi un rebond virologique du VIH. En elle-même, la co-infection par le VHB n’était pas prédictive de la suppression virologique ou du risque de rebond. Le taux de suppression virologique était plus faible chez les patients ayant des antécédents de consommation de drogues injectables ou une numération des cellules CD4 de référence de moins de 199 cellules par millimètre cube. Un ARN du VIH de référence bas et les hommes ayant des relations sexuelles avec des hommes étaient associés de manière significative avec un taux plus élevé de suppression virologique. La consommation de drogues injectables et les races non blanches étaient prédictives d’un rebond viral.

Conclusion: Les patients atteints du VHB co-infectés par le VIH obtenaient des résultats antirétroviraux semblables à ceux qui étaient seulement infectés par le VIH. On peut anticiper des résultats cliniques équitables des traitements en ciblant les ressources vers les sous-populations atteintes d’une co-infection par le VIH et le VHB.

Keywords: HIV; antiretroviral efficacy; co-infection; hepatitis B; virological suppression.

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Conflict of interest statement

SW reports grants, personal fees, non-financial support, and other from Merck, Gilead, GSK, ViiV Healthcare, and Janssen outside the submitted work. MK reports personal fees from ViiV Healthcare, Bristol-Meyers Squibb, AbbVie, and Merck, outside the submitted work. DK reports grants and personal fees from Gilead Sciences, Merck Canada, and ViiV Healthcare and grants from AbbVie Canada, outside the submitted work. RH reports grants from CIHR during the conduct of the study and grants from CIHR outside the submitted work. CLC reports grants and personal fees from Merck, Gilead, AbbVie, and Bristol-Meyers-Squibb, outside the submitted work.

Figures

**Figure 1:**
Time to virological suppression by hepatitis B infection status

**Figure 2:**
Time to virological rebound by hepatitis B infection status

See this image and copyright information in PMC

References

1. World Health Organization. Global hepatitis report, 2017. Geneva: World Health Organization; 2017.
1. Joint United Nations Programme on HIV/AIDS. Global AIDS update 2016. Geneva: UNAIDS. 2016.
1. Alter MJ. Epidemiology of viral hepatitis and HIV co-infection. J Hepatol. 2006;44(Suppl. 1):S6–S9. 10.1016/j.jhep.2005.11.004. Medline: - DOI - PubMed
1. Spradling P, Richardson J, Buchacz K, Moorman A, Brooks J; HIV Outpatient Study Investigators. Prevalence of chronic hepatitis B virus infection among patients in the HIV Outpatient Study, 1996–2007. J Viral Hepat. 2010;17(12):879–86. 10.1111/j.1365-2893.2009.01249.x. Medline: - DOI - PubMed
1. Singh KP, Crane M, Audsley J, Avihingsanon A, Sasadeusz J, Lewin SR. HIV-hepatitis B virus coinfection: epidemiology, pathogenesis, and treatment. AIDS. 2017;31(15):2035–52. 10.1097/QAD.0000000000001574. Medline: - DOI - PMC - PubMed

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Clinical and demographic predictors of antiretroviral efficacy in HIV-HBV co-infected patients

Affiliations

Clinical and demographic predictors of antiretroviral efficacy in HIV-HBV co-infected patients

Authors

Affiliations

Abstract
in English, French

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Research Materials

Abstract in English, French

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Research Materials

Abstract
in English, French