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Intensification with pegylated interferon during treatment with tenofovir in HIV –hepatitis B virus co‐infected patients
Author(s) -
Boyd A.,
Piroth L.,
Maylin S.,
MaynardMuet M.,
Lebossé F.,
Bouix C.,
LascouxCombe C.,
Mahjoub N.,
Girard P.M.,
Delaugerre C.,
Carrat F.,
Lacombe K.,
Miailhes P.
Publication year - 2016
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/jvh.12581
Subject(s) - medicine , pegylated interferon , gastroenterology , hbsag , hbeag , hepatitis b virus , hepatitis b , immunology , hepatitis c virus , virus , ribavirin
Summary In hepatitis B “e” antigen ( HB eAg) positive patients with hepatitis B virus ( HBV ) mono‐infection, intensification of nucleos(t)ide analogue treatment with pegylated interferon (Peg IFN ) could help induce higher HB eAg seroclearance rates. Our aim was to determine the long‐term effect of adding Peg IFN to tenofovir ( TDF )‐containing antiretroviral therapy on seroclearance in HB eAg‐positive patients co‐infected with the human immunodeficiency virus ( HIV ) and HBV . In this prospective matched cohort study, 46 patients with 1‐year Peg IFN intensification during TDF ‐containing antiretroviral therapy ( TDF +Peg IFN ) were matched 1:1 to controls undergoing TDF without Peg IFN ( TDF ) using a time‐dependent propensity score based on age, CD 4+ count and liver cirrhosis status. Kinetics of HB eAg quantification ( qHBeA g) and hepatitis B surface antigen quantification ( qHBsA g) were estimated using mixed‐effect linear regression and time to HB eAg seroclearance or HB sAg seroclearance was modelled using proportional hazards regression. At baseline, previous TDF exposure was a median 39.8 months ( IQR =21.4–59.4) and median qHBeA g and qHBsA g levels were 6.9 PEIU / mL and 3.72 log 10 IU / mL , respectively ( P >.5 between groups). Median follow‐up was 33.4 months ( IQR =19.0–36.3). During intensification, faster average declines of qHBeA g (−0.066 vs −0.027 PEIU / mL /month, P =.001) and qHBsA g (−0.049 vs −0.026 log 10 IU / mL /month, P =.09) were observed in patients undergoing TDF +Peg IFN vs TDF , respectively. After intensification, qHBeA g and qHBsA g decline was no different between groups ( P =.7 and P =.9, respectively). Overall, no differences were observed in HB eAg seroclearance ( TDF +Peg IFN =13.2 vs TDF =12.6/100 person·years, P =.5) or HB sAg seroclearance rates ( TDF +Peg IFN =1.8 vs TDF =1.3/100 person·years, P =.7). In conclusion, Peg IFN intensification in HB eAg‐positive co‐infected patients did not lead to increased rates of HB eAg or HB sAg clearance, despite faster declines of antigen levels while on PegIFN.