Frequent Hepatitis B Virus Rebound Among HIV-hepatitis B Virus-coinfected Patients Following Antiretroviral Therapy Interruption

Overview

Journal AIDS

Specialty Infectious Diseases

Date 2010 Mar 11

PMID 20216301

Citations 25

Authors

Gregory J Dore

Vicente Soriano

Jurgen Rockstroh

Bernd Kupfer

Ellen Tedaldi

Lars Peters

Jacqueline Neuhaus

Massimo Puoti

Marina B Klein

Amanda Mocroft

Bonaventura Clotet

Jens D Lundgren

Affiliations

Soon will be listed here.

Abstract

Background: The impact of antiretroviral therapy (ART) interruption in HIV-hepatitis B virus (HBV)-coinfected patients was examined in the Strategic Management of AntiRetroviral Therapy (SMART) study.

Methods: Plasma HBV DNA was measured in all hepatitis B surface antigen-positive (HBV-positive) participants at baseline, and at months 1, 2, 4, 6, 8, 10, and 12.

Results: Among HBV-positive participants in the ART interruption (drug conservation) (n = 72) and ART continuation (virological suppression) (n = 62) arms, HBV DNA rebound of more than 1 log from baseline at months 1-4 was seen in 31-33% (P = 0.003) and 3-4% (P = 0.017), respectively. Thirteen HBV-positive participants had HBV DNA rebound of more than 3 log, including 12 in the drug conservation arm, of which eight were on tenofovir-containing regimens. Factors independently associated with a HBV DNA rebound were drug conservation arm (P = 0.0002), nondetectable HBV DNA at baseline (P = 0.007), and black race (P = 0.03). Time to ART reinitiation was shorter (7.5, 15.6, and 17.8 months; P < 0.0001) and proportion reinitiating greater (62.5, 46.5, and 39.7%; P = 0.0002) among HBV-positive participants as compared with hepatitis C virus-positive and non-HBV/hepatitis C virus participants in the drug conservation arm. No hepatic decompensation events occurred among HBV-positive participants in either arm.

Conclusion: HBV DNA rebound following ART interruption is common and may be associated with accelerated immune deficiency in HIV-HBV-coinfected patients.

Citing Articles

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