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Longitudinal evaluation of viral interactions in treated HIV‐hepatitis B co‐infected patients with additional hepatitis C and D virus
Author(s) -
Boyd A.,
Lacombe K.,
Miailhes P.,
Gozlan J.,
Bonnard P.,
Molina J.M.,
LascouxCombe C.,
Serfaty L.,
Gault E.,
Desvarieux M.,
Girard P.M.
Publication year - 2010
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2009.01153.x
Subject(s) - hepatitis d virus , lamivudine , virology , medicine , hepatitis b virus , hepatitis b , hepatitis d , coinfection , hepatitis c virus , hepatitis c , viral load , human immunodeficiency virus (hiv) , virus , hbsag
Summary Virological interactions of hepatitis B (HBV), hepatitis C (HCV) and hepatitis D (HDV) viruses in HIV‐infected patients have been poorly characterized especially under treatment influences. Undetection rates of hepatitis viruses were longitudinally analyzed in a 3‐year cohort of 308 HIV–HBV co‐infected patients and compared using Generalized Estimating Equation models adjusted for age, HIV‐RNA, CD4 cell‐count and antiviral treatment. Chronic hepatitis co‐infection in HIV‐infected patients (age years, SD) was: 265 HBV (40.7, 8.2); 19 HBV–HCV (39.7, 4.1); 12 HBV–HDV (35.2, 9.9); 12 HBV–HCV–HDV (39.2, 5.2). At inclusion, treatment with lamivudine/tenofovir was not significantly different between co‐infection groups. HBV suppression was significantly associated with HDV (aOR = 3.85, 95%CI 1.13–13.10, P = 0.03) and HCV tri‐infection (aOR = 2.65, 95%CI 1.03–6.81, P = 0.04), but marginally associated with HIV–HBV–HCV–HDV (aOR = 2.32, 95%CI 0.94–5.74, P = 0.07). In quad‐infection, lower HDV‐undetectability ( vs HIV–HBV–HDV, P = 0.2) and higher HCV‐undetectability ( vs HIV–HBV–HCV, P = 0.1) were demonstrated. The degree of HBV suppression varied between visits and co‐infection groups [range of aOR during follow‐up ( vs HIV–HBV co‐infection): HIV–HBV–HCV = 2.23–5.67, HIV–HBV–HDV = 1.53–15.17]. In treated co‐infected patients, HDV expressed continuous suppression over HCV‐ and HBV‐replications. Peaks and rebounds from undetectable hepatitis B, C and/or D viremia warrant closer follow‐up in this patient population. HDV‐replication was uncontrolled even with antiviral treatment.