Predictors of HBeAg status and hepatitis B viraemia in HIV-infected patients with chronic hepatitis B in the HAART era in Brazil

BMC Infectious Diseases

David E Uip²  Reinaldo J Gianini⁴  Mariliza H Silva⁵  Andréa G Leite¹  Luiz G Martins⁵  Cristina F Guastini¹  Adriana C da Silva¹  Michele S Gomes-Gouvea³  João RR Pinho³  Maria Cassia Mendes-Correa¹ 

[1] Department of Infectious Diseases Medical School, University of São Paulo, São Paulo, Brazil;Infectious Diseases Research Unit, ABC Medical School, Santo André, Brazil;Tropical Medicine Institute and Department of Gastroenterology, Medical School, University of São Paulo, São Paulo, Brazil;Laboratory of Medical Investigation in Epidemiology and Statistics, Medical School, University of São Paulo, São Paulo, Brazil;AIDS Outpatient Clinic, São Bernardo do Campo, São Paulo, Brazil

关键词: tenofovir;    virological outcome;    HIV;    hepatitis B virus;   

Others  :  1175602
DOI  :  10.1186/1471-2334-11-247

 received in 2011-02-22, accepted in 2011-09-20,  发布年份 2011

【 摘 要 】

Background

HBV-HIV co-infection is associated with an increased liver-related morbidity and mortality. However, little is known about the natural history of chronic hepatitis B in HIV-infected individuals under highly active antiretroviral therapy (HAART) receiving at least one of the two drugs that also affect HBV (TDF and LAM). Information about HBeAg status and HBV viremia in HIV/HBV co-infected patients is scarce. The objective of this study was to search for clinical and virological variables associated with HBeAg status and HBV viremia in patients of an HIV/HBV co-infected cohort.

Methods

A retrospective cross-sectional study was performed, of HBsAg-positive HIV-infected patients in treatment between 1994 and 2007 in two AIDS outpatient clinics located in the São Paulo metropolitan area, Brazil. The baseline data were age, sex, CD4 T+ cell count, ALT level, HIV and HBV viral load, HBV genotype, and duration of antiretroviral use. The variables associated to HBeAg status and HBV viremia were assessed using logistic regression.

Results

A total of 86 HBsAg patients were included in the study. Of these, 48 (56%) were using combination therapy that included lamivudine (LAM) and tenofovir (TDF), 31 (36%) were using LAM monotherapy, and 7 patients had no previous use of either one. Duration of use of TDF and LAM varied from 4 to 21 and 7 to 144 months, respectively. A total of 42 (48. 9%) patients were HBeAg positive and 44 (51. 1%) were HBeAg negative. The multivariate analysis revealed that the use of TDF for longer than 12 months was associated with undetectable HBV DNA viral load (serum HBV DNA level < 60 UI/ml) (p = 0. 047). HBeAg positivity was associated with HBV DNA > 60 UI/ml (p = 0. 001) and ALT levels above normality (p = 0. 038).

Conclusion

Prolonged use of TDF containing HAART is associated with undetectable HBV DNA viral load. HBeAg positivity is associated with HBV viremia and increased ALT levels.

【 授权许可】

   
2011 Mendes-Correa et al; licensee BioMed Central Ltd.

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