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Obstacles to HBV functional cure: Late presentation in HIV and its impact on HBV seroconversion in HIV/HBV coinfection
Author(s) -
Bremen Kathrin,
Hoffmann Christian,
Mauss Stefan,
Lutz Thomas,
Ingiliz Patrick,
Spinner Christoph D.,
Scholten Stefan,
SchwarzeZander Carolynne,
Berger Florian,
Breitschwerdt Sven,
Schneeweiss Stephan,
Busch Fabian,
Wasmuth JanChristian,
Fätkenheuer Gerd,
Lehmann Clara,
Rockstroh Jürgen K.,
Boesecke Christoph
Publication year - 2020
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14684
Subject(s) - hbsag , medicine , coinfection , seroconversion , hepatitis b virus , cohort , human immunodeficiency virus (hiv) , hepatitis b , virology , gastroenterology , immunology , virus
Abstract Several cohorts have shown that long‐term tenofovir‐containing combination antiretroviral therapy (cART) leads to higher HBsAg seroclearance rates in HIV/HBV coinfected patients vs HBV‐monoinfected patients under tenofovir disoproxil fumarate (TDF)‐based therapy. We have analysed data on determinants of HBsAg loss in a retrospective multicentric cohort of 359 HIV/HBV coinfected patients. Median CD4 T‐cell count at baseline was 359/ul (321‐404), CDC stage was C in 20% (n = 70). Most patients (68%) were ART‐naïve when TDF‐ or tenofovir alafenamide (TAF)‐containing cART was initiated (baseline). After a median follow‐up of 11 years HBsAg loss had occurred in 66/359 (18%) patients. However, patients with stage CDC C ( P ≤ .001), lower CD4 gain ( P = .043) and not receiving TDF/FTC ( P = .008) were less likely to lose HBsAg. Long‐term TDF‐containing cART appears to achieve higher rates of HBsAg seroclearance compared to published data for HBV monoinfected subjects. However, late presentation for HIV and poor immune recovery significantly impair HBV seroconversion rates.