Differential clinical and virologic impact of hepatitis B virus genotypes B and C on HIV-coinfected patients receiving lamivudine-containing highly active antiretroviral therapy.

Abstract

BACKGROUND:

 The impact of hepatitis B virus (HBV) genotypes B and C on the clinical, immunologic, and virologic outcomes of human immunodeficiency virus (HIV)-infected patients with chronic HBV infection remains largely unknown.

METHODS:

 Between January 1997 and December 2008, we enrolled 96 HIV-infected patients with HBV genotype B coinfection and 49 with genotype C coinfection; the patients were followed prospectively until December 2010. Clinical and immunologic outcomes in the context of HBV genotypes as well as the emergence of HBV DNA mutations conferring lamivudine resistance (rtM204I/V) were determined.

RESULTS:

 The median duration of lamivudine-containing highly active antiretroviral therapy (HAART) was 2.80 years (interquartile range, 1.73-5.92 years). The 2 groups of HIV-infected patients were comparable in age, sex, baseline HIV profiles, and liver function profiles. Compared with HIV-infected patients with HBV genotype C coinfection, those with genotype B coinfection had a higher risk of hepatitis flares (43.8% vs 26.5%; P = .04), liver disease-related death (9.4% vs 0%; P = .03), hepatitis B e antigen (HBeAg) seroconversion (61.5% vs 25.0%, P = .03), and development of lamivudine resistance (31.3% vs 12.2%; P < .0001). No differences were observed between the 2 groups in terms of the development of hyperbilirubinemia, cirrhosis, or virologic and immunologic responses to HAART.

CONCLUSIONS:

 Although therapeutic responses to long-term lamivudine-containing HAART were comparable between HIV-infected patients with HBV genotypes B and C coinfection, patients with genotype B coinfection were more likely to experience acute exacerbations of hepatitis, HBeAg seroconversion, lamivudine resistance, and liver disease-related death than those with genotype C coinfection.

• Authors: Wang-Huei Sheng, Chien-Ching Hung, Sui-Yuan Chang, Chun-Jen Liu, Mao-Yuan Chen, Szu-Min Hsieh, Jia-Horng Kao, Pei-Jer Chen, Shan-Chwen Chang
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 54 Issue 4 Pg. 548-55 (Feb 15 2012) ISSN: 1537-6591 [Electronic] United States
• PMID: 22156858 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• DNA, Viral
• Hepatitis B Surface Antigens
• Lamivudine

Topics

• Adult
• Antiretroviral Therapy, Highly Active (methods)
• Antiviral Agents (administration & dosage)
• Cohort Studies
• DNA, Viral (genetics)
• Drug Resistance, Viral
• Female
• Genotype
• HIV Infections (complications, drug therapy)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B virus (classification, genetics, isolation & purification)
• Hepatitis B, Chronic (complications, virology)
• Humans
• Lamivudine (administration & dosage)
• Liver (pathology)
• Male
• Middle Aged
• Prospective Studies
• Treatment Outcome