Long-term observation on hepatitis B surface antigen seroclearance in therapy experienced HIV/HBV co-infected Chinese

J Viral Hepat. 2020 Feb;27(2):127-134. doi: 10.1111/jvh.13212. Epub 2019 Oct 28.

Abstract

The aim of this retrospective study was to observe hepatitis B surface antigen (HBsAg) seroclearance and explore predictors of HBsAg loss in HIV/HBV-co-infected patients receiving long-term lamivudine or both tenofovir and lamivudine containing therapies. Quantification of HBsAg, hepatitis B e antigen and HBV DNA before and after initiation of HBV-active antiretroviral therapy in a total of 268 HIV/HBV-co-infected patients started treatment between 2005 and 2017 were performed. Over a median of 65.63 months of follow-up, 10 (3.7%) were observed HBsAg loss and the quantification of HBsAg in 7 (2.6%) patients were less than 50 IU/mL. With the prolongation of antiretroviral therapy duration time, the rates of HBsAg seroclearance tended to increase gradually, rising from 1.8% (3/163) during 2-4 years treatment to 29.4% (10/34) after antiretroviral therapy for up to 10 years. Lower baseline qHBsAg and HBV DNA levels and strong 12-month declines in qHBsAg were significantly associated with HBsAg seroclearance. The event of HBsAg seroclearance is uncommon among Chinese individuals with HIV/HBV co-infection who have been treated with anti-HBV containing antiretroviral therapy, and lifelong therapy for HBV is needed for HIV/HBV co-infected patients. Baseline qHBsAg and HBV DNA levels and qHBsAg decline rate were predictors for HBsAg seroclearance.

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

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Asian People
  • China
  • Coinfection / drug therapy
  • Coinfection / ethnology
  • Coinfection / virology*
  • DNA, Viral / blood
  • Drug Therapy, Combination
  • Female
  • HIV Infections / ethnology
  • HIV Infections / virology*
  • Hepatitis B / drug therapy
  • Hepatitis B / ethnology
  • Hepatitis B / virology*
  • Hepatitis B Surface Antigens / blood*
  • Humans
  • Lamivudine / therapeutic use
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tenofovir / therapeutic use
  • Time Factors
  • Young Adult

Substances

  • Anti-HIV Agents
  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B Surface Antigens
  • Lamivudine
  • Tenofovir