TY - JOUR
T1 - Association of hepatitis B Core-related antigen and antihepatitis B core antibody with liver fibrosis evolution in human immunodeficiency virus-hepatitis B virus coinfected patients during treatment with tenofovir
AU - Cruchet, Romuald
AU - Dezanet, Lorenza N.C.
AU - Maylin, Sarah
AU - Gabassi, Audrey
AU - Rougier, Hayette
AU - Miailhes, Patrick
AU - Lascoux-Combe, Caroline
AU - Chas, Julie
AU - Girard, Pierre Marie
AU - Delaugerre, Constance
AU - Lacombe, Karine
AU - Boyd, Anders
N1 - Funding Information: This study has been sponsored by the Institut de M?decine et d'Epid?miologie Appliqu?e (IMEA). L. N. C. D. was awarded a postdoctoral fellowship from the Agence Nationale de Recherches sur le Sida et les H?patites Virales (ANRS). Funding Information: This study has been sponsored by the Institut de Médecine et d’Epidémiologie Appliquée (IMEA). L. N. C. D. was awarded a postdoctoral fellowship from the Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS). Funding Information: Financial support. This work was funded by SIDACTION (grant AO 19), the ANRS France REcherche Nord&sud Sida-hiv Hépatites (research grant to the French HIV-HBV cohort and a postdoctoral fellowship to L. N. C. D.), and Gilead Sciences (unrestricted grant to the French HIV-HBV Cohort). Publisher Copyright: © The Author(s) 2020.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background. Quantitative hepatitis B core-related antigen (qHBcrAg) or antihepatitis B core antibody (qAnti-HBc) could be useful in monitoring liver fibrosis evolution during chronic hepatitis B virus (HBV) infection, yet it has not been assessed in human immunodeficiency virus (HIV)-HBV-coinfected patients undergoing treatment with tenofovir (TDF). Methods. One hundred fifty-four HIV-HBV-infected patients initiating a TDF-containing antiretroviral regimen were prospectively followed. The qHBcrAg and qAnti-HBc and liver fibrosis assessment were collected every 6-12 months during TDF. Hazard ratios (HRs) assessing the association between qHBcrAg/qAnti-HBc and transitions from none/mild/significant fibrosis to advanced fibrosis/cirrhosis (progression) and from advanced fibrosis/cirrhosis to none/mild/significant fibrosis (regression) were estimated using a time-homogeneous Markov model. Results. At baseline, advanced liver fibrosis/cirrhosis was observed in 40 (26%) patients. During a median follow-up of 48 months (interquartile range, 31-90), 38 transitions of progression (IR = 7/100 person-years) and 34 transitions of regression (IR = 6/100 person-years) were observed. Baseline levels of qHBcrAg and qAnti-HBc were not associated with liver fibrosis progression (adjusted-HR per log10 U/mL = 1.07, 95% confidence interval [CI] = 0.93-1.24; adjusted-HR per log10 Paul-Ehrlich-Institute [PEI] U/mL = 0.85, 95% CI = 0.70-1.04, respectively) or regression (adjusted-HR per log10 U/mL = 1.17, 95% CI = 0.95-1.46; adjusted-HR per log10 PEI U/mL = 0.97, 95% CI = 0.78-1.22, respectively) after adjusting for age, gender, duration of antiretroviral therapy, protease inhibitor-containing antiretroviral therapy, and CD4+/CD8+ ratio. Nevertheless, changes from the previous visit of qAnti-HBc levels were associated with liver fibrosis regression (adjusted-HR per log10 PEIU/ mL change = 5.46, 95% CI = 1.56-19.16). Conclusions. Baseline qHBcrAg and qAnti-HBc levels are not associated with liver fibrosis evolution in TDF-treated HIVHBV coinfected patients. The link between changes in qAnti-HBc levels during follow-up and liver fibrosis regression merits further study.
AB - Background. Quantitative hepatitis B core-related antigen (qHBcrAg) or antihepatitis B core antibody (qAnti-HBc) could be useful in monitoring liver fibrosis evolution during chronic hepatitis B virus (HBV) infection, yet it has not been assessed in human immunodeficiency virus (HIV)-HBV-coinfected patients undergoing treatment with tenofovir (TDF). Methods. One hundred fifty-four HIV-HBV-infected patients initiating a TDF-containing antiretroviral regimen were prospectively followed. The qHBcrAg and qAnti-HBc and liver fibrosis assessment were collected every 6-12 months during TDF. Hazard ratios (HRs) assessing the association between qHBcrAg/qAnti-HBc and transitions from none/mild/significant fibrosis to advanced fibrosis/cirrhosis (progression) and from advanced fibrosis/cirrhosis to none/mild/significant fibrosis (regression) were estimated using a time-homogeneous Markov model. Results. At baseline, advanced liver fibrosis/cirrhosis was observed in 40 (26%) patients. During a median follow-up of 48 months (interquartile range, 31-90), 38 transitions of progression (IR = 7/100 person-years) and 34 transitions of regression (IR = 6/100 person-years) were observed. Baseline levels of qHBcrAg and qAnti-HBc were not associated with liver fibrosis progression (adjusted-HR per log10 U/mL = 1.07, 95% confidence interval [CI] = 0.93-1.24; adjusted-HR per log10 Paul-Ehrlich-Institute [PEI] U/mL = 0.85, 95% CI = 0.70-1.04, respectively) or regression (adjusted-HR per log10 U/mL = 1.17, 95% CI = 0.95-1.46; adjusted-HR per log10 PEI U/mL = 0.97, 95% CI = 0.78-1.22, respectively) after adjusting for age, gender, duration of antiretroviral therapy, protease inhibitor-containing antiretroviral therapy, and CD4+/CD8+ ratio. Nevertheless, changes from the previous visit of qAnti-HBc levels were associated with liver fibrosis regression (adjusted-HR per log10 PEIU/ mL change = 5.46, 95% CI = 1.56-19.16). Conclusions. Baseline qHBcrAg and qAnti-HBc levels are not associated with liver fibrosis evolution in TDF-treated HIVHBV coinfected patients. The link between changes in qAnti-HBc levels during follow-up and liver fibrosis regression merits further study.
KW - Antihepatitis B core antibody
KW - Cirrhosis
KW - Hepatitis B core-related antigen
KW - Human immunodeficiency virus
KW - Liver fibrosis
UR - http://www.scopus.com/inward/record.url?scp=85090761879&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ofid/ofaa215
DO - https://doi.org/10.1093/ofid/ofaa215
M3 - Article
SN - 2328-8957
VL - 7
JO - Open forum infectious diseases
JF - Open forum infectious diseases
IS - 7
M1 - ofaa215
ER -