Premium
Hepatitis B surface antigen quantification as a predictor of seroclearance during treatment in HIV‐hepatitis B virus coinfected patients from Sub‐Saharan Africa
Author(s) -
Boyd Anders,
Maylin Sarah,
Moh Raoul,
Mahjoub Nadia,
Gabillard Delphine,
Eholié Serge Paul,
Danel Christine,
Anglaret Xavier,
Zoulim Fabien,
Girard PierreMarie,
Delaugerre Constance
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13156
Subject(s) - medicine , hbsag , hbeag , interquartile range , gastroenterology , hepatitis b virus , hepatitis b , lamivudine , virology , virus
Abstract Background and Aim In Sub‐Saharan Africa, seroclearance of hepatitis B surface antigen (HBsAg) and hepatitis B “e” antigen (HBeAg), including their quantifiable markers, have rarely been evaluated during long‐term antiviral treatment among patients coinfected with HIV and hepatitis B virus (HBV). Methods In this prospective cohort study from two randomized‐control trials in Côte d'Ivoire, 161 antiretroviral‐naïve HIV‐HBV coinfected patients starting lamivudine ( n = 76) or tenofovir/emtricitabine ( n = 85) containing antiretroviral therapy were included. HBV DNA was quantified using an in‐house assay (detection limit = 12 copies/mL) and HBsAg quantification (qHBsAg) using the Elecsys assay. Results Overall, 33 (20.5%) patients were HBeAg positive, 121 (75.2%) had detectable HBV DNA, and 92/93 (98.9%) harbored HBV genotype E. Median treatment duration was 35.5 months (interquartile range: 24.3–36.4). Among HBeAg‐positive patients, cumulative proportion with HBeAg seroclearance was 46.3% ( n = 14). Overall, cumulative proportion of HBsAg seroclearance was 6.6% ( n = 10). Lower baseline qHBsAg levels and strong 12‐month declines in qHBsAg were significantly associated with HBsAg seroclearance for both HBeAg‐negative and HBeAg‐positive patients. When taken at certain levels, these determinants provided moderate sensitivity (Se) and specificity (Sp) in predicting HBsAg seroclearance at month 36 (≤ 1000 IU/mL at baseline, Se = 0.80, Sp = 0.80; ≥ 1.0 log 10 IU/mL drop at month 12, Se = 0.57, Sp = 1.00). Instead, qHBsAg levels ≤ 100 or ≤ 10 IU/mL at month 12 were optimal (both Se = 0.90 and Sp = 1.00). Detectable HBV‐DNA provided fairly high Se and Sp when evaluated at baseline (Se = 1.00, Sp = 0.80), but not at month 12 (Se = 0.80, Sp = 0.40). Conclusions HBsAg seroclearance rates are not common in patients from Sub‐Saharan Africa treated with anti‐HBV containing antiretroviral therapy. qHBsAg levels at 12 months of treatment may accurately predict HBsAg seroclearance.