Hepatitis B Virus Coinfection Negatively Impacts HIV Outcomes in HIV Seroconverters

Chun, Helen M.; Roediger, Mollie P.; Hullsiek, Katherine Huppler; Thio, Chloe L.; Agan, Brian K.; Bradley, William P.; Peel, Sheila A.; Jagodzinski, Linda L.; Weintrob, Amy; Ganesan, Anuradha; Wortmann, Glenn; Crum-Cianflone, Nancy F.; Maguire, Jason D.; Landrum, Michael L.

doi:10.1093/infdis/jir720

Cited by 113 publications

(112 citation statements)

References 38 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Infection with HBV is not always considered in the management of HIV infection, [4] although co-infection has been associated with increased turnover rate of HIV RNA-increased liver morbidity, and complicated HIV pathology. [5][6][7] On the other hand, the use of highly active antiretroviral therapy (HAART) with a lamivudine component is used for HIV treatment in South Africa, and would be expected to be associated with the development of HBV drug-resistant strains, since lamivudine is the sole active drug (monotherapy) against HBV.…”

mentioning

confidence: 99%

Hepatitis B virus in HIV-infected patients in north-eastern South Africa: Prevalence, exposure, protection and response to HAART

Ayuk

Mphahlele

2013

S Afr Med J

View full text Add to dashboard Cite

Objective. Hepatitis B virus (HBV) and HIV are endemic infections in many African countries. The objectives of this study were to determine the levels of exposure to, and protection from, HBV, as well as the prevalence of HIV/HBV co-infection and the response of HBV to highly active anti-retroviral therapy (HAART) in a cross-section of HIV-infected patients in north-eastern South Africa. Study design. This was a laboratory-based, unmatched study. Three hundred and eighty patients were screened by ELISA for HBsAg, anti-HBc and anti-HBs. Samples non-reactive for HBsAg but reactive for anti-HBc were examined for occult HBV infection. Response to HAART was assessed by measuring HBV viral loads, seroconversion from HBeAg to anti-HBe, and levels of aminotransferase. Results. Of the study population of 380, 60% (95% CI 54.8 -64.9) were exposed to HBV based on HBsAg, anti-HBs or anti-HBc; 20% (95% CI 16.1 -24.4) had active HBV infection, based on HBsAg serology, and 30% (95% CI 25.2 -35.2) were protected, based on anti-HBs levels ≥10 IU/l. Of 181 HBsAg-negative individuals, 61 had HBV occult infection (33.7%, 95% CI 26.9 -41.1). The differences in prevalence were not statistically significant when gender, marital status and CD4+ cell counts were considered. Of 21 patients analysed, 80% showed adequate response to the first-line HAART regimen (stavudine/lamivudine/efavirenz or nevirapine) after 12 months of use. Conclusion. The study confirms the higher level (60%) of exposure to HBV in HIV patients in Limpopo Province, as well as the high (20%) prevalence of HBsAg positivity and occult hepatitis B (33.7%). However, further studies are warranted to corroborate the benefit of lamivudine-containing HAART regimens, as HIV/HBV co-infected patients have a higher liver-related mortality if hepatitis B is not treated.

show abstract

mentioning

confidence: 99%

Hepatitis B virus in HIV-infected patients in north-eastern South Africa: Prevalence, exposure, protection and response to HAART

Ayuk

Mphahlele

2013

S Afr Med J

View full text Add to dashboard Cite

show abstract

“…2,45 Further, chronic HBV is associated with poorer HIV outcomes, with a nearly twofold higher risk of AIDS/death. 46 Hence, all HIV-infected persons without evidence of HBV immunity should be vaccinated.…”

Section: Pneumococcalmentioning

confidence: 99%

Vaccination in HIV-Infected Adults

Crum-Cianflone

Wallace

2014

AIDS Patient Care and STDs

Self Cite

View full text Add to dashboard Cite

Vaccines are critical components for protecting HIV-infected adults from an increasing number of preventable diseases. However, missed opportunities for vaccination among HIV-infected persons persist, likely due to concerns regarding the safety and efficacy of vaccines, as well as the changing nature of vaccine guidelines. In addition, the optimal timing of vaccination among HIV-infected adults in regards to HIV stage and receipt of antiretroviral therapy remain important questions. This article provides a review of the current recommendations regarding vaccines among HIV-infected adults and a comprehensive summary of the evidence-based literature of the benefits and risks of vaccines among this vulnerable population. Importance of Vaccinations for HIV Patients

show abstract

“…A further side effect is that a combination of various ART drugs given to suppress the replication of HIV-1 in a chronic hepatitis B patient may lead to deadly acute liver failure due to severe hepatotoxicity [25]. Treatment of a recently coinfected patient shortly after HIV-1 seroconversion doubles the hazard for an AIDS or death event [26], indicating that not all of the pathogenic interactions of HBV and HIV-1 coinfection are known.…”

Section: Pathogenicitymentioning

confidence: 99%

Effect of Antiretroviral HIV Therapy on Hepatitis B Virus Replication and Pathogenicity

Gürtler¹

2014

Intervirology

View full text Add to dashboard Cite

Coinfections with hepatitis B virus (HBV) and HIV are very frequent. Although HBV is a DNA virus, it replicates via reverse transcription like HIV. Structural similarities between the enzymatic pocket of the HBV DNA polymerase and HIV-1 reverse transcriptase are the basis that certain drugs inhibit both enzymes and thus the replication of both viruses. HBV components increase the pathogenic action of HIV and vice versa directly by certain proteins like HBsAg in the case of HBV and HIV-encoded Tat and Vpr and by disturbing the cytokine balance in affected cells. Antiretroviral therapy is highly beneficial for HIV/HBV-coinfected patients, but carries the risk of drug-induced resistance development and hepatotoxicity. Even with restoration of the immune capacity, signs of hepatic inflammation may develop even after 10 years of treatment.

show abstract

Hepatitis B Virus Coinfection Negatively Impacts HIV Outcomes in HIV Seroconverters

Abstract: HBV coinfection has a significant impact on HIV outcomes. The hazard for an AIDS or death event is almost double for those with chronic HB compared, with HIV-monoinfected persons.

Cited by 113 publications

References 38 publications

Hepatitis B virus in HIV-infected patients in north-eastern South Africa: Prevalence, exposure, protection and response to HAART

Hepatitis B virus in HIV-infected patients in north-eastern South Africa: Prevalence, exposure, protection and response to HAART

Vaccination in HIV-Infected Adults

Effect of Antiretroviral HIV Therapy on Hepatitis B Virus Replication and Pathogenicity

Contact Info

Product

Resources

About