Uptake of Tenofovir-Based Antiretroviral Therapy among HIV–HBV-Coinfected Patients in the EuroSIDA Study

Peters, Lars; Mocroft, Amanda; Grint, Daniel; Moreno, Santiago; Calmy, Alexandra; Jevtović, Djordje; Sambatakou, Helen; Lacombe, Karine; Wit, Stéphane De; Rockstroh, Jürgen K.; Šmidt, Jelena; Karpov, Igor; Grzeszczuk, Anna; Haziosmanovic, Vesnadarjan; Gottfreðsson, Magnús; Rădoi, Roxana; Kuzovatova, Elena; Orkin, Chloe; Ridolfo, Anna Lisa; Zapirain, Jose Joaquin Portu; Lundgren, Jens D

doi:10.3851/imp3218

Cited by 5 publications

(4 citation statements)

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“…In our study, the increased incidence was mainly in those who were HBV DNA positive, suggesting a role of replicating HBV in nonliver malignancies [1]. We found a significant increase over time in the percentage of persons treated with TDF/TAF ± XTC in all included individuals, most marked in those who were currently HBV positive, consistent with previous findings from EuroSIDA [28]. During 2019, 50% of the follow‐up among those who were currently HBV negative included treatment with TDF/TAF ± XTC compared to 75% for those who were currently positive, reflecting current treatment guidelines recommending that all HIV/HBV‐coinfected persons be treated with TDF or TAF‐based antiretrovirals [29].…”

Section: Discussionsupporting

confidence: 91%

The association between hepatitis B virus infection and nonliver malignancies in persons living with HIV: results from the EuroSIDA study

et al. 2021

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Objectives The aim of this study was to assess the impact of hepatitis B virus (HBV) infection on non‐liver malignancies in people living with HIV (PLWH). Methods All persons aged ≥ 18 years with known hepatitis B virus (HBV) surface antigen (HBsAg) status after the latest of 1 January 2001 and enrolment in the EuroSIDA cohort (baseline) were included in the study; persons were categorized as HBV positive or negative using the latest HBsAg test and followed to their first diagnosis of nonliver malignancy or their last visit. Results Of 17 485 PLWH included in the study, 1269 (7.2%) were HBV positive at baseline. During 151 766 person‐years of follow‐up (PYFU), there were 1298 nonliver malignancies, 1199 in those currently HBV negative [incidence rate (IR) 8.42/1000 PYFU; 95% confidence interval (CI) 7.94–8.90/1000 PYFU] and 99 in those HBV positive (IR 10.54/1000 PYFU; 95% CI 8.47–12.62/1000 PYFU). After adjustment for baseline confounders, there was a significantly increased incidence of nonliver malignancies in HBV‐positive versus HBV‐negative individuals [adjusted incidence rate ratio (aIRR) 1.23; 95% CI 1.00–1.51]. Compared to HBV‐negative individuals, HBsAg‐positive/HBV‐DNA‐positive individuals had significantly increased incidences of nonliver malignancies (aIRR 1.37; 95% CI 1.00–1.89) and NHL (aIRR 2.57; 95% CI 1.16–5.68). There was no significant association between HBV and lung or anal cancer. Conclusions We found increased rates of nonliver malignancies in HBsAg‐positive participants, the increases being most pronounced in those who were HBV DNA positive and for NHL. If confirmed, these results may have implications for increased cancer screening in HIV‐positive subjects with chronic HBV infection.

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Section: Discussionsupporting

confidence: 91%

The association between hepatitis B virus infection and nonliver malignancies in persons living with HIV: results from the EuroSIDA study

et al. 2021

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“…The preferable choice of using tenofovir as a backbone can be guided by clinical benefits: tenofovir has potent anti-HBV activity, 41 and given the lack of testing for hepatitis B in most LMICs, where HIV and HBV prevalence is high, tenofovir is the preferred option, over abacavir. Secondly, HLA testing for HLA B*5701 is recommended where abacavir use is being considered due to the possibility of hypersensitivity reactions with this allele 42 .…”

Section: Discussionmentioning

confidence: 99%

Predicted antiviral activity of tenofovir versus abacavir in combination with a cytosine analogue and the integrase inhibitor dolutegravir in HIV-1-infected South African patients initiating or failing first-line ART

Derache

Iwuji

Danaviah

et al. 2018

Journal of Antimicrobial Chemotherapy

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ObjectivesThe WHO recently recommended the use of a new first-line ART containing dolutegravir. We investigated the efficacy of NRTI backbones (tenofovir or abacavir with a cytosine analogue) in low- and middle-income countries where there is significant prior exposure to antiretrovirals and drug resistance to NRTIs.MethodsWithin the treatment-as-prevention study in South Africa, we selected participants with available next-generation sequencing (NGS) data for the HIV-1 pol gene at trial entry; they were either ART initiators (n = 1193) or already established on ART (n = 94). NGS of the HIV-1 pol gene was carried out using MiSeq technology; reverse transcriptase drug resistance mutations (DRMs) were detected at 5% (DRM5%) and 20% (DRM20%) for all 1287 participants. Genotypic susceptibility was assessed using the Stanford HIVDB resistance interpretation algorithm.ResultsNRTI DRM20% and DRM5% were detected among 5/1193 (0.4%) and 9/1193 (0.8%) of ART initiators, respectively. There was tenofovir exposure in 73/94 (77.7%) of those established on ART, with full susceptibility to abacavir in 57/94 (60.6%) and 56/94 (59.6%) for DRM20% and DRM5%, respectively, while 67/94 (71.3%) and 64/94 (68.1%) were fully susceptible to tenofovir, respectively. The differences between tenofovir and abacavir were not statistically significant at the 20% or 5% variant level (P = 0.16 and 0.29, respectively). NGS detection of variants at the 5% level increased detection of K65R in both naive and treated groups. One of 607 integrase sequences carried a DRM20% (Q148R).ConclusionsDolutegravir with a cytosine analogue plus tenofovir or abacavir appears to have similar efficacy in South Africans naive to ART. NGS should be considered in HIV drug resistance surveillance.

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“…Nucleoside analog drugs such as lamivudine, 3TC; emtricitabine, FTC; tenofovir disoproxil fumarate, TDF; and tenofovir alafenamide, TAF, suppress HBV replication and can control HIV replication during HBV/HIV co-infection. The use of TDF-based combined antiretroviral therapy (cART) to treat this co-infection has increased over the years [18], and is now the standard for nucleoside analog backbone. However, functional cure achievement rates and related factors to HBV resolution in this setting have not yet been fully characterized [4].…”

Section: Introductionmentioning

confidence: 99%

Higher rates of HBsAg clearance with tenofovir-containing therapy in HBV/HIV co-infection

Gantner¹,

Cotte²,

Allavena³

et al. 2019

PLoS ONE

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Introduction Achieving functional cure of chronic HBV infection (Hepatitis B surface antigen [HBsAg] clearance, eventually followed by acquisition of anti-hepatitis B surface antigen [Anti-HBs]) in individuals with HIV and HBV infections is a rare event. In this setting, factors related to HBV cure have not yet been fully characterized. Methods HIV-infected individuals with chronic HBV infection enrolled in the French Dat’AIDS cohort (NCT02898987), who started combined antiretroviral (cART)-anti-HBV treatment were retrospectively analyzed for HBsAg loss and Anti-HBs seroconversion. Results Overall, 1419 naïve-subjects received three different cART-anti-HBV treatment schedule: (1) 3TC or FTC only (n = 150), (2) TDF with or without 3TC or FTC (n = 489) and (3) 3TC or FTC as first line followed by adding/switching to TDF as second line (n = 780). Individuals were followed-up for a median of 89 months (IQR, 56–118). HBV-DNA was < 15 IU/mL in 91% of individuals at the end of the follow-up. Overall, 97 individuals cleared HBsAg (0.7/100 patient-years), of whom, 67 seroconverted for Anti-HBs (0.5/100 patient-years). A high CD4 nadir, a short delay between HBV diagnosis and treatment, a longer time on HBV therapy, an African origin and TDF-based therapy were independent predictors of HBsAg clearance (Probability of odds ratio [OR]>1, >95%) suggested by Bayesian analysis. Also, TDF-based regimen as first line (OR, 3.03) or second line (OR, 2.95) increased rates of HBsAg clearance compared to 3TC or FTC alone, with a 99% probability. Conclusions HBsAg clearance rate was low in HIV-HBV co-infected cART-anti-HBV treated individuals, but was slightly improved on TDF-based regimen.

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Uptake of Tenofovir-Based Antiretroviral Therapy among HIV–HBV-Coinfected Patients in the EuroSIDA Study

Abstract: Background: According to guidelines all HIV/HBV co-infected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV/HBV patients in the EuroSIDA study.

Cited by 5 publications

References 11 publications

The association between hepatitis B virus infection and nonliver malignancies in persons living with HIV: results from the EuroSIDA study

The association between hepatitis B virus infection and nonliver malignancies in persons living with HIV: results from the EuroSIDA study

Predicted antiviral activity of tenofovir versus abacavir in combination with a cytosine analogue and the integrase inhibitor dolutegravir in HIV-1-infected South African patients initiating or failing first-line ART

Higher rates of HBsAg clearance with tenofovir-containing therapy in HBV/HIV co-infection

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