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. 2023 Feb 8:13:1130485.
doi: 10.3389/fcimb.2023.1130485. eCollection 2023.

Incidence and predictors of HBV functional cure in patients with HIV/HBV coinfection: A retrospective cohort study

Qingrong Zhang  1 , Hu Wang  2 , Yi Jin  3 , Na Zhou  4   5 , Lijun Sun  2 , Hao Wu  2 , Haitao Chen  1 , Taiyi Jiang  2
Affiliations

Incidence and predictors of HBV functional cure in patients with HIV/HBV coinfection: A retrospective cohort study

Qingrong Zhang et al. Front Cell Infect Microbiol. .

Abstract

Background: This study was the first to examine the association of baseline clinical factors with the rate of HBsAg clearance in a large retrospective cohort of Chinese patients with HIV/HBV coinfection treated with combination antiretroviral therapy (ART).

Methods: Our retrospective cohort included 431 patients with HIV/HBV coinfection treated with TDF-containing ART. The median follow-up was 6.26 years. Logistic regression was used to investigate the association of baseline variables with HBsAg clearance, and Cox regression was used to investigate the association of baseline variables with time to HBsAg clearance.

Results: The clearance rate of HBsAg in our study was 0.072 (95% CI 0.049~0.101). In the multivariate logistic regression, advanced age (OR=1.1, P=0.007), high CD4 cell count (OR=2.06, P=0.05), and HBeAg positivity (OR=8.00, P=0.009) were significantly associated with the rate of HBsAg clearance. The AUC of the model integrating the above three predictors was 0.811. Similar results were found in the multivariate Cox regression (HR = 1.09, P = 0.038 for age, HR = 1.05, P = 0.012 for CD4 count and HR = 7.00, P = 0.007 for HBeAg).

Conclusions: Long-term TDF-containing ART can lead to HBsAg clearance of 7.2% in Chinese patients with HIV/HBV coinfection. Advanced age, high CD4 cell count, and positive HBeAg at baseline could be regarded as potential predictors and biological markers for HBsAg clearance in patients with HIV/HBV coinfection.

Keywords: HBeAg; HBsAg; antiretroviral therapy; chronic hepatitis B; human immunodeficiency virus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study population inclusion. *Acute HBV infection was defined as the persistence of HBsAg within 6 months.
Figure 2
Figure 2
AUC of the two models in the multivariate logistic regression.
Figure 3
Figure 3
Kaplan–Meier plots of the cumulative hazard of HBsAg clearance stratified by the baseline status of HBeAg and age. (A) Stratified by the baseline status of HBeAg (positive HBeAg at baseline or negative HBeAg at baseline); (B) stratified by age (age<35 or age>=35).
Figure 4
Figure 4
Cumulative frequency of HBsAg clearance stratified by the baseline status of HBeAg and age. (A) Stratified by the baseline status of HBeAg (positive HBeAg at baseline or negative HBeAg at baseline); (B) stratified by age (age<35 or age>=35).
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