Hepatitis B and HIV: prevalence, AIDS progression, response to highly active antiretroviral therapy and increased mortality in the EuroSIDA cohort.

Abstract

BACKGROUND:

Whether hepatitis B (HBV) coinfection affects outcome in HIV-1-infected patients remains unclear.

OBJECTIVE:

To assess the prevalence of HBV (assessed as HBsAg) coinfection and its possible impact on progression to AIDS, all-cause deaths, liver-related deaths and response to highly active antiretroviral therapy (HAART) in the EuroSIDA cohort.

METHODS:

Data on 9802 patients in 72 European HIV centres were analysed. Incidence rates of AIDS, global mortality and liver-related mortality, time to 25% CD4 cell count increase and time to viral load < 400 copies/ml after starting HAART were calculated and compared between HBsAg-positive and HBsAg-negative patients.

RESULTS:

HBsAg was found in 498 (8.7%) patients. The incidence of new AIDS diagnosis was similar in HBsAg-positive and HBsAg-negative patients (3.3 and 3.4/100 person-years, respectively) even after adjustment for potential confounders: the incidence rate ratio (IRR) was 0.94 [95% confidence interval (CI), 0.74-1.19; P = 0.61]. The incidences of all-cause and liver-related mortalities were significantly higher in HBsAg-positive subjects (3.7 and 0.7/100 person-years, respectively) compared with HBsAg-negative subjects (2.6 and 0.2/100 person-years, respectively). The adjusted IRR values were 1.53 for global (95% CI, 1.23-1.90; P = 0.0001) and 3.58 for liver-related (95% CI, 2.09-6.16; P < 0.0001) mortality. HBsAg status did not influence viral or immunological responses among the 1679 patients starting HAART.

CONCLUSIONS:

The prevalence of HBV coinfection was 9% in the EuroSIDA cohort. Chronic HBV infection significantly increased liver-related mortality in HIV-1-infected patients but did not impact on progression to AIDS or on viral and immunological responses to HAART.

• Authors: Deborah Konopnicki, Amanda Mocroft, S de Wit, Francisco Antunes, Bruno Ledergerber, Christine Katlama, K Zilmer, Stefano Vella, Ole Kirk, Jens D Lundgren, EuroSIDA Group
• Journal: AIDS (London, England) (AIDS) Vol. 19 Issue 6 Pg. 593-601 (Mar 24 2005) ISSN: 0269-9370 [Print] England
• PMID: 15802978 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Hepatitis B Surface Antigens

Topics

• Adult
• Antiretroviral Therapy, Highly Active
• Cause of Death
• Cohort Studies
• Disease Progression
• Europe (epidemiology)
• HIV Infections (complications, drug therapy, mortality)
• HIV-1
• Hepatitis B Surface Antigens (blood)
• Hepatitis B, Chronic (complications, mortality)
• Humans
• Male
• Prevalence