TY - JOUR
T1 - Clinical Outcomes during Treatment Interruptions in Human Immunodeficiency Virus-Hepatitis B Virus Co-infected Patients from Sub-Saharan Africa
AU - the ANRS 1269 Trivacan and ANRS 12240 VarBVA Studies
AU - Boyd, Anders
AU - Houghtaling, Laura
AU - Moh, Raoul
AU - Chekaraou, Mariama Abdou
AU - Gabillard, Delphine
AU - Eholié, Serge Paul
AU - Anglaret, Xavier
AU - Zoulim, Fabien
AU - Danel, Christine
AU - Lacombe, Karine
AU - Matthieu, Abanou
AU - Isabelle, Adou
AU - Adou, Aman
AU - Ibouraîma, Bakayoko
AU - Léontine, Bombo
AU - Edwidge, Cissé
AU - Ali, Coulibaly
AU - Lucien, Djédjé
AU - Edouard, Djobi Djo
AU - Jocelyn, Goly
AU - Marie-Cécile, Kassi
AU - Justine, Koffi
AU - Aholi, Koffi N.Dri
AU - Sylvie, Konan
AU - Mamadou, Konaté
AU - Bertin, Kouadio
AU - Martin, Kouamé
AU - Martin, Kouadio
AU - Victoire, Kouadio
AU - Adrienne, Kouakou
AU - Yao, Kouakou
AU - Antoine, Kouamé
AU - Ferdinand, Kouamé
AU - Gérald, Kouamé
AU - Justine, Kouamé
AU - Georgette, Labibi
AU - Jean, Lehou
AU - Jules, Moh
AU - Mariam, Moussa Doumbia
AU - Marie-Pierre, Martin
AU - Julie, N'Dri Marie
AU - Tuo, Nalourgou
AU - Célestin, N'Chot
AU - Brou, N'Goran
AU - Marie-Pascale, Nogbout
AU - Joanna, Orne Gliemann
AU - Bakary, Ouattara
AU - Minata, Ouattara
AU - Joséphine, Oupoh
AU - Abdelh, Sidibé
N1 - Funding Information: Financial support: This study was supported by funds from the Agence Nationale de Recherche sur le Sida et les Hépatites (ANRS 1269/ANRS 12104 and ANRS 12240). A post-doctoral fellowship from the ANRS and SIDACTION was awarded to A. B. for some of the work presented in this manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: This study was supported by funds from the Agence Nationale de Recherche sur le Sida et les H?patites (ANRS 1269/ANRS 12104 and ANRS 12240). A post-doctoral fellowship from the ANRS and SIDACTION was awarded to A. B. for some of the work presented in this manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: Copyright © 2017 by The American Society of Tropical Medicine and Hygiene
PY - 2017/12
Y1 - 2017/12
N2 - Antiretroviral treatment (ART) interruptions increase the risk of severe morbidity/mortality in human immunodeficiency virus (HIV)-infected individuals from subSaharan Africa. We aimed to determine whether the risk is further increased among HIV-hepatitis B virus (HBV) co-infected patients in this setting. In this sub-analysis of a randomized-control trial, 632 participants from Côte d'Ivoire randomized to receive continuous-ART (C-ART), structured ART interruptions of 2-months off, 4-months on (2/4-ART), and CD4-guided ART interruptions (CD4GT, interruption at 350/mm3 and reintroduction at 250/mm3) were analyzed. Incidence rates (IR) of serious HIV- and non-HIV-related morbidity were compared between patients stratified on hepatitis B surface antigen (HBsAg) status. Overall, 65 (10.3%) were HBsAg-positive, 29 (44.6%) of whom had HBV-DNA levels > 10,000 copies/mL. After a median 2.0 year (range = 0.2-3.1) followup, 3 1 serious HIV-related events occurred in 101 HIV mono-infected and 15 HIV-HBV co-infected patients (IR = 10.0 versus 13.2/100 person/years, respectively, P = 0.3), whereas the highest incidence was observed in co-infected patients with baseline HBV-replication > 10,000 copies/mL (IR = 24.0/100 person/years, P versus HIV mono-infected = 0.002). Incidence of bacterial infections was also highest in the co-infected group with HBV-replication > 10,000 copies/mL (IR = 12.9 versus 3.3/100 person/years in HIV mono-infected patients, P = 0.001). The relative effect of CD4GT or 2/4-ART versus C-ART was not different between infection groups (P for interaction = 0.4). No increase in the incidence of non-HIV-related morbidity was observed for co-infected patients (P = 0.5), even at HBV-replication levels > 10,000 copies/mL (P = 0.7). In conclusion, co-infected patients with elevated HBV-replication at ART-initiation are more susceptible to HIV-related morbidity, especially invasive bacterial diseases, during treatment interruption.
AB - Antiretroviral treatment (ART) interruptions increase the risk of severe morbidity/mortality in human immunodeficiency virus (HIV)-infected individuals from subSaharan Africa. We aimed to determine whether the risk is further increased among HIV-hepatitis B virus (HBV) co-infected patients in this setting. In this sub-analysis of a randomized-control trial, 632 participants from Côte d'Ivoire randomized to receive continuous-ART (C-ART), structured ART interruptions of 2-months off, 4-months on (2/4-ART), and CD4-guided ART interruptions (CD4GT, interruption at 350/mm3 and reintroduction at 250/mm3) were analyzed. Incidence rates (IR) of serious HIV- and non-HIV-related morbidity were compared between patients stratified on hepatitis B surface antigen (HBsAg) status. Overall, 65 (10.3%) were HBsAg-positive, 29 (44.6%) of whom had HBV-DNA levels > 10,000 copies/mL. After a median 2.0 year (range = 0.2-3.1) followup, 3 1 serious HIV-related events occurred in 101 HIV mono-infected and 15 HIV-HBV co-infected patients (IR = 10.0 versus 13.2/100 person/years, respectively, P = 0.3), whereas the highest incidence was observed in co-infected patients with baseline HBV-replication > 10,000 copies/mL (IR = 24.0/100 person/years, P versus HIV mono-infected = 0.002). Incidence of bacterial infections was also highest in the co-infected group with HBV-replication > 10,000 copies/mL (IR = 12.9 versus 3.3/100 person/years in HIV mono-infected patients, P = 0.001). The relative effect of CD4GT or 2/4-ART versus C-ART was not different between infection groups (P for interaction = 0.4). No increase in the incidence of non-HIV-related morbidity was observed for co-infected patients (P = 0.5), even at HBV-replication levels > 10,000 copies/mL (P = 0.7). In conclusion, co-infected patients with elevated HBV-replication at ART-initiation are more susceptible to HIV-related morbidity, especially invasive bacterial diseases, during treatment interruption.
UR - http://www.scopus.com/inward/record.url?scp=85038129575&partnerID=8YFLogxK
U2 - https://doi.org/10.4269/AJTMH.16-1016
DO - https://doi.org/10.4269/AJTMH.16-1016
M3 - Article
C2 - 29141712
SN - 0002-9637
VL - 97
SP - 1936
EP - 1942
JO - American journal of tropical medicine and hygiene
JF - American journal of tropical medicine and hygiene
IS - 6
ER -