Higher rates of HBsAg clearance with tenofovir-containing therapy in HBV/HIV co-infection
Pierre Gantner, Laurent Cotte, Clotilde Allavena, Firouzé Bani-Sadr, Thomas Huleux, Claudine Duvivier, Marc-Antoine Valantin, Christine Jacomet, Véronique Joly, Antoine Chéret, Pascal Pugliese, Pierre Delobel, André Cabié, David Rey, Dat’AIDS Study Group, Pierre Gantner, Laurent Cotte, Clotilde Allavena, Firouzé Bani-Sadr, Thomas Huleux, Claudine Duvivier, Marc-Antoine Valantin, Christine Jacomet, Véronique Joly, Antoine Chéret, Pascal Pugliese, Pierre Delobel, André Cabié, David Rey, Dat’AIDS Study Group
Abstract
Introduction: Achieving functional cure of chronic HBV infection (Hepatitis B surface antigen [HBsAg] clearance, eventually followed by acquisition of anti-hepatitis B surface antigen [Anti-HBs]) in individuals with HIV and HBV infections is a rare event. In this setting, factors related to HBV cure have not yet been fully characterized.
Methods: HIV-infected individuals with chronic HBV infection enrolled in the French Dat'AIDS cohort (NCT02898987), who started combined antiretroviral (cART)-anti-HBV treatment were retrospectively analyzed for HBsAg loss and Anti-HBs seroconversion.
Results: Overall, 1419 naïve-subjects received three different cART-anti-HBV treatment schedule: (1) 3TC or FTC only (n = 150), (2) TDF with or without 3TC or FTC (n = 489) and (3) 3TC or FTC as first line followed by adding/switching to TDF as second line (n = 780). Individuals were followed-up for a median of 89 months (IQR, 56-118). HBV-DNA was < 15 IU/mL in 91% of individuals at the end of the follow-up. Overall, 97 individuals cleared HBsAg (0.7/100 patient-years), of whom, 67 seroconverted for Anti-HBs (0.5/100 patient-years). A high CD4 nadir, a short delay between HBV diagnosis and treatment, a longer time on HBV therapy, an African origin and TDF-based therapy were independent predictors of HBsAg clearance (Probability of odds ratio [OR]>1, >95%) suggested by Bayesian analysis. Also, TDF-based regimen as first line (OR, 3.03) or second line (OR, 2.95) increased rates of HBsAg clearance compared to 3TC or FTC alone, with a 99% probability.
Conclusions: HBsAg clearance rate was low in HIV-HBV co-infected cART-anti-HBV treated individuals, but was slightly improved on TDF-based regimen.
Conflict of interest statement
The authors have declared that no competing interests exist.
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References
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