The kinetics of the hepatitis B surface antigen level after the initiation of antiretroviral therapy for hepatitis B virus and human immunodeficiency virus coinfected patients.

Abstract

BACKGROUND:

Hepatic flares (HF), which reflect hepatitis B virus (HBV)-related immune reconstitution inflammatory syndrome (IRIS), frequently occur in patients with HBV and human immunodeficiency virus (HIV) coinfection after the start of antiretoroviral therapy (ART). The rate of hepatitis B envelope antigen (HBeAg) and hepatitis B surface antigen (HBsAg) loss is higher for patients with HF after the initiation of ART.

METHODS:

We retrospectively examined the kinetics of the HBsAg and HBeAg levels of six HBV/HIV coinfected patients after the commencement of ART that included tenofovir. All were male and HBeAg positive.

RESULTS:

Three patients developed HF after the initiation of ART. All subsequently lost HBeAg and one of them lost HBsAg after HF. None who did not experience HF lost HBeAg. The HBsAg and HBeAg levels remarkably decreased when HF occurred, but the decline of HBsAg was very slow in the periods before and after HF. The median decline of the HBsAg level at 48 weeks was 2.20 Log IU/mL for patients with HF, but only 1.00 Log IU/ml for patients without HF. Little decline was seen for either group in the median decline of the HBsAg level from 48 weeks to 96 weeks, 0.28 Log IU/mL in the HF group and 0.06 Log IU/mL in the non-HF group.

CONCLUSION:

The immune reconstitution of a HBV/HIV coinfected patient plays an important role in the clearance of HBV. If HBsAg and HBeAg levels decrease rapidly when HF occurs, the hepatic flare would be due to HBV-related IRIS.

• Authors: Fujiko Mitsumoto, Masayuki Murata, Kazuya Ura, Koji Takayama, Satoshi Hiramine, Motohiro Shimizu, Kazuhiro Toyoda, Eiichi Ogawa, Norihiro Furusyo, Jun Hayashi
• Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 21 Issue 4 Pg. 264-71 (Apr 2015) ISSN: 1437-7780 [Electronic] Netherlands
• PMID: 25596071 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Retroviral Agents
• DNA, Viral
• Hepatitis B Surface Antigens
• Hepatitis B e Antigens
• RNA, Viral
• Tenofovir

Topics

• Adult
• Anti-Retroviral Agents (administration & dosage, pharmacology, therapeutic use)
• Coinfection (drug therapy, epidemiology, virology)
• DNA, Viral (blood)
• Female
• HIV Infections (drug therapy, epidemiology)
• Hepatitis B (complications, drug therapy, epidemiology, virology)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B e Antigens (blood)
• Humans
• Immune Reconstitution Inflammatory Syndrome
• Kinetics
• Male
• Middle Aged
• RNA, Viral (blood)
• Retrospective Studies
• Tenofovir (administration & dosage, pharmacology, therapeutic use)
• Viral Load
• Young Adult