Risks and Benefits of Oral HIV Pre-exposure Prophylaxis for People with Chronic Hepatitis B

Overview

Journal Lancet HIV

Specialty Infectious Diseases

Date 2022 Jul 11

PMID 35817068

Authors

Amir M Mohareb

Joseph Larmarange

Arthur Y Kim

Patrick A Coffie

Menan Gerard Kouame

Anders Boyd

Kenneth A Freedberg

Emily P Hyle

Affiliations

Soon will be listed here.

Abstract

Individuals with chronic hepatitis B virus (HBV) infection who are at substantial risk of HIV acquisition benefit from pre-exposure prophylaxis (PrEP) with tenofovir-based antiviral therapy. Considering that tenofovir potently inhibits HBV, providing PrEP to individuals with HBV effectively results in treatment of their HBV infection. However, some clinicians might be hesitant to initiate PrEP in people with chronic HBV due to unknown risks of HBV reactivation, hepatitis, and acute liver failure during periods of antiviral cessation. Unfortunately, these knowledge gaps affect scale up of PrEP among people with chronic HBV. Emerging data regarding the risks and benefits of antiviral cessation in people with chronic HBV suggest that PrEP can be safely initiated despite the risks of non-adherence or discontinuation. People with chronic HBV who stop PrEP should be closely monitored for HBV reactivation and hepatitis flares after antiviral cessation.

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References

Becquet V, Nouaman M, Plazy M, Masumbuko J, Anoma C, Kouame S . Sexual health needs of female sex workers in Côte d'Ivoire: a mixed-methods study to prepare the future implementation of pre-exposure prophylaxis (PrEP) for HIV prevention. BMJ Open. 2020; 10(1):e028508. PMC: 6955511. DOI: 10.1136/bmjopen-2018-028508. View

Marcellin P, Heathcote E, Buti M, Gane E, de Man R, Krastev Z . Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B. N Engl J Med. 2008; 359(23):2442-55. DOI: 10.1056/NEJMoa0802878. View

Mason L, Duffell E, Veldhuijzen I, Petriti U, Bunge E, Tavoschi L . Hepatitis B and C prevalence and incidence in key population groups with multiple risk factors in the EU/EEA: a systematic review. Euro Surveill. 2019; 24(30). PMC: 6668290. DOI: 10.2807/1560-7917.ES.2019.24.30.1800614. View

Falla A, Hofstraat S, Duffell E, Hahne S, Tavoschi L, Veldhuijzen I . Hepatitis B/C in the countries of the EU/EEA: a systematic review of the prevalence among at-risk groups. BMC Infect Dis. 2018; 18(1):79. PMC: 5809955. DOI: 10.1186/s12879-018-2988-x. View

Jeng W, Lok A . Should Treatment Indications for Chronic Hepatitis B Be Expanded?. Clin Gastroenterol Hepatol. 2020; 19(10):2006-2014. DOI: 10.1016/j.cgh.2020.04.091. View

Tan M, Bhadoria A, Cui F, Tan A, Holten J, Easterbrook P . Estimating the proportion of people with chronic hepatitis B virus infection eligible for hepatitis B antiviral treatment worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020; 6(2):106-119. PMC: 7801814. DOI: 10.1016/S2468-1253(20)30307-1. View

Lampertico P, Berg T . Less can be more: A finite treatment approach for HBeAg-negative chronic hepatitis B. Hepatology. 2018; 68(2):397-400. DOI: 10.1002/hep.29821. View

Ghany M, Feld J, Chang K, Chan H, Lok A, Visvanathan K . Serum alanine aminotransferase flares in chronic hepatitis B infection: the good and the bad. Lancet Gastroenterol Hepatol. 2020; 5(4):406-417. PMC: 7158588. DOI: 10.1016/S2468-1253(19)30344-9. View

Iloeje U, Yang H, Jen C, Su J, Wang L, You S . Risk and predictors of mortality associated with chronic hepatitis B infection. Clin Gastroenterol Hepatol. 2007; 5(8):921-31. DOI: 10.1016/j.cgh.2007.06.015. View

10.

Desalegn H, Aberra H, Berhe N, Mekasha B, Stene-Johansen K, Krarup H . Treatment of chronic hepatitis B in sub-Saharan Africa: 1-year results of a pilot program in Ethiopia. BMC Med. 2018; 16(1):234. PMC: 6296040. DOI: 10.1186/s12916-018-1229-x. View

11.

Berg T, Simon K, Mauss S, Schott E, Heyne R, Klass D . Long-term response after stopping tenofovir disoproxil fumarate in non-cirrhotic HBeAg-negative patients - FINITE study. J Hepatol. 2017; 67(5):918-924. DOI: 10.1016/j.jhep.2017.07.012. View

12.

Sarin S, Kumar M, Lau G, Abbas Z, Chan H, Chen C . Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2015; 10(1):1-98. PMC: 4722087. DOI: 10.1007/s12072-015-9675-4. View

13.

Papatheodoridis G, Vlachogiannakos I, Cholongitas E, Wursthorn K, Thomadakis C, Touloumi G . Discontinuation of oral antivirals in chronic hepatitis B: A systematic review. Hepatology. 2016; 63(5):1481-92. DOI: 10.1002/hep.28438. View

14.

Thigpen M, Kebaabetswe P, Paxton L, Smith D, Rose C, Segolodi T . Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012; 367(5):423-34. DOI: 10.1056/NEJMoa1110711. View

15.

Luz P, Osher B, Grinsztejn B, MacLean R, Losina E, Stern M . The cost-effectiveness of HIV pre-exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil. J Int AIDS Soc. 2018; 21(3):e25096. PMC: 5878414. DOI: 10.1002/jia2.25096. View

16.

Marrazzo J, Ramjee G, Richardson B, Gomez K, Mgodi N, Nair G . Tenofovir-based preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2015; 372(6):509-18. PMC: 4341965. DOI: 10.1056/NEJMoa1402269. View

17.

Peterson L, Taylor D, Roddy R, Belai G, Phillips P, Nanda K . Tenofovir disoproxil fumarate for prevention of HIV infection in women: a phase 2, double-blind, randomized, placebo-controlled trial. PLoS Clin Trials. 2007; 2(5):e27. PMC: 1876601. DOI: 10.1371/journal.pctr.0020027. View

18.

. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100):1151-1210. PMC: 5605883. DOI: 10.1016/S0140-6736(17)32152-9. View

19.

Mokaya J, McNaughton A, Bester P, Goedhals D, Barnes E, Marsden B . Hepatitis B virus resistance to tenofovir: fact or fiction? A systematic literature review and structural analysis of drug resistance mechanisms. Wellcome Open Res. 2021; 5:151. PMC: 8033640. DOI: 10.12688/wellcomeopenres.15992.1. View

20.

Terrault N, Bzowej N, Chang K, Hwang J, Jonas M, Murad M . AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2015; 63(1):261-83. PMC: 5987259. DOI: 10.1002/hep.28156. View