Factors associated with delayed hepatitis b viral suppression on tenofovir among patients coinfected with HBV-HIV in the CNICS cohort

H. Nina Kim, Carla V. Rodriguez, Stephen Van Rompaey, Joseph J. Eron, Chloe L. Thio, Heidi M. Crane, Edgar T. Overton, Michael S. Saag, Jeffrey Martin, Elvin Geng, Michael Mugavero, Benigno Rodriguez, W. Christopher Mathews, Stephen Boswell, Richard Moore, Mari M. Kitahata

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14 Scopus citations

Abstract

BACKGROUND: Despite widespread use in HIV and hepatitis B virus (HBV) infection, the effectiveness of tenofovir (TDF) has not been studied extensively outside of small cohorts of coinfected patients with HBV-HIV. We examined the effect of prior lamivudine (3TC) treatment and other factors on HBV DNA suppression with TDF in a multisite clinical cohort of coinfected patients. METHODS: We studied all patients enrolled in the Centers for AIDS Research Network of Integrated Clinical Systems cohort from 1996 to 2011 who had chronic HBV and HIV infection, initiated a TDF-based regimen continued for ≥3 months and had on-treatment HBV DNA measurements. We used Kaplan-Meier curves and Cox-proportional hazards to estimate time to suppression (HBV DNA level <200 IU/mL or <1000 copies/mL) by selected covariates. RESULTS: Among 397 coinfected patients on TDF, 91% were also on emtricitabine or 3TC concurrently, 92% of those tested were hepatitis B e antigen positive, 196 (49%) had prior 3TC exposure; 192 (48%) achieved HBV DNA suppression over a median of 28 months (interquartile range: 13-71). Median time to HBV DNA suppression was 17 months for those who were 3TC-naive and 50 months for those who were 3TC exposed. After controlling for other factors, prior 3TC exposure, baseline HBV DNA level >10,000 IU/mL, and lower nadir CD4 count were independently associated with decreased likelihood of HBV DNA suppression on TDF. CONCLUSIONS: These results emphasize the role of prior 3TC exposure and immune response on delayed HBV suppression on TDF.

Original languageEnglish
Pages (from-to)96-101
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume66
Issue number1
DOIs
StatePublished - May 1 2014
Externally publishedYes

Keywords

  • HIV
  • hepatitis B virus
  • lamivudine
  • tenofovir

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    Kim, H. N., Rodriguez, C. V., Van Rompaey, S., Eron, J. J., Thio, C. L., Crane, H. M., Overton, E. T., Saag, M. S., Martin, J., Geng, E., Mugavero, M., Rodriguez, B., Mathews, W. C., Boswell, S., Moore, R., & Kitahata, M. M. (2014). Factors associated with delayed hepatitis b viral suppression on tenofovir among patients coinfected with HBV-HIV in the CNICS cohort. Journal of Acquired Immune Deficiency Syndromes, 66(1), 96-101. https://doi.org/10.1097/QAI.0000000000000126