HIV outcomes in hepatitis B virus coinfected individuals on HAART

Helen M. Chun; Octavio Mesner; Chloe L. Thio; Ionut Bebu; Grace Macalino; Brian K. Agan; William P. Bradley; Jennifer Malia; Sheila A. Peel; Linda L. Jagodzinski; Amy C. Weintrob; Anuradha Ganesan; Mary Bavaro; Jason D. Maguire; Michael L. Landrum

doi:10.1097/QAI.0000000000000142

HIV outcomes in hepatitis B virus coinfected individuals on HAART

Helen M. Chun, Octavio Mesner, Chloe L. Thio, Ionut Bebu, Grace Macalino, Brian K. Agan, William P. Bradley, Jennifer Malia, Sheila A. Peel, Linda L. Jagodzinski, Amy C. Weintrob, Anuradha Ganesan, Mary Bavaro, Jason D. Maguire, Michael L. Landrum

School of Medicine

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Background: Understanding the impact of hepatitis B virus (HBV) coinfection on HIV outcomes in the highly active antiretroviral therapy (HAART) era continues to be a critical priority given the high prevalence of coinfection and the potential for impaired immunologic, virologic, and clinical recovery. Methods: Participants from the US Military HIV Natural History Study with an HIV diagnosis on HAART and serologically confirmed HBV infection status at HAART initiation (HI) were classified into 4 HBV infection (HB) groups. HIV virologic, immunologic, and clinical outcomes were evaluated by HB status. Results: Of 2536 HIV-positive HAART recipients, with HBV testing results available to determine HB status in the HI window, HB status at HI was classified as HB negative (n = 1505; 66%), resolved HB (n = 518; 23%), isolated hepatitis B core antigen (n = 139; 6%), or chronic HB (n = 131; 6%). HIV virologic suppression and failure at 6 months or 1 year were not significantly different by HB status. A significantly faster rate of increase in CD4 cell count during the period between 4 and 12 years was observed for chronic HB relative to HB negative. Chronic and resolved HB were associated with an increased risk of AIDS/death compared with HB-negative individuals (chronic HB - hazard ratio = 1.68, 95% confidence interval: 1.05 to 2.68; resolved HB - hazard ratio = 1.61, 95% confidence interval: 1.15 to 2.25). Conclusions: HB status did not have a significant impact on HIV virologic outcomes, however, CD4 cell count reconstitution after HI and the risk of an AIDS event or death after HI may be associated with HB status.

Original language	English (US)
Pages (from-to)	197-205
Number of pages	9
Journal	Journal of Acquired Immune Deficiency Syndromes
Volume	66
Issue number	2
DOIs	https://doi.org/10.1097/QAI.0000000000000142
State	Published - Jun 1 2014

Keywords

HIV
chronic hepatitis B
hepatitis B virus
highly active antiretroviral therapy

ASJC Scopus subject areas

Infectious Diseases
Pharmacology (medical)

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10.1097/QAI.0000000000000142

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Chun, H. M., Mesner, O., Thio, C. L., Bebu, I., Macalino, G., Agan, B. K., Bradley, W. P., Malia, J., Peel, S. A., Jagodzinski, L. L., Weintrob, A. C., Ganesan, A., Bavaro, M., Maguire, J. D., & Landrum, M. L. (2014). HIV outcomes in hepatitis B virus coinfected individuals on HAART. Journal of Acquired Immune Deficiency Syndromes, 66(2), 197-205. https://doi.org/10.1097/QAI.0000000000000142

Chun, HM, Mesner, O, Thio, CL, Bebu, I, Macalino, G, Agan, BK, Bradley, WP, Malia, J, Peel, SA, Jagodzinski, LL, Weintrob, AC, Ganesan, A, Bavaro, M, Maguire, JD & Landrum, ML 2014, 'HIV outcomes in hepatitis B virus coinfected individuals on HAART', Journal of Acquired Immune Deficiency Syndromes, vol. 66, no. 2, pp. 197-205. https://doi.org/10.1097/QAI.0000000000000142

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abstract = "Background: Understanding the impact of hepatitis B virus (HBV) coinfection on HIV outcomes in the highly active antiretroviral therapy (HAART) era continues to be a critical priority given the high prevalence of coinfection and the potential for impaired immunologic, virologic, and clinical recovery. Methods: Participants from the US Military HIV Natural History Study with an HIV diagnosis on HAART and serologically confirmed HBV infection status at HAART initiation (HI) were classified into 4 HBV infection (HB) groups. HIV virologic, immunologic, and clinical outcomes were evaluated by HB status. Results: Of 2536 HIV-positive HAART recipients, with HBV testing results available to determine HB status in the HI window, HB status at HI was classified as HB negative (n = 1505; 66%), resolved HB (n = 518; 23%), isolated hepatitis B core antigen (n = 139; 6%), or chronic HB (n = 131; 6%). HIV virologic suppression and failure at 6 months or 1 year were not significantly different by HB status. A significantly faster rate of increase in CD4 cell count during the period between 4 and 12 years was observed for chronic HB relative to HB negative. Chronic and resolved HB were associated with an increased risk of AIDS/death compared with HB-negative individuals (chronic HB - hazard ratio = 1.68, 95% confidence interval: 1.05 to 2.68; resolved HB - hazard ratio = 1.61, 95% confidence interval: 1.15 to 2.25). Conclusions: HB status did not have a significant impact on HIV virologic outcomes, however, CD4 cell count reconstitution after HI and the risk of an AIDS event or death after HI may be associated with HB status.",

keywords = "HIV, chronic hepatitis B, hepatitis B virus, highly active antiretroviral therapy",

author = "Chun, {Helen M.} and Octavio Mesner and Thio, {Chloe L.} and Ionut Bebu and Grace Macalino and Agan, {Brian K.} and Bradley, {William P.} and Jennifer Malia and Peel, {Sheila A.} and Jagodzinski, {Linda L.} and Weintrob, {Amy C.} and Anuradha Ganesan and Mary Bavaro and Maguire, {Jason D.} and Landrum, {Michael L.}",

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doi = "10.1097/QAI.0000000000000142",

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T1 - HIV outcomes in hepatitis B virus coinfected individuals on HAART

AU - Chun, Helen M.

AU - Mesner, Octavio

AU - Thio, Chloe L.

AU - Bebu, Ionut

AU - Macalino, Grace

AU - Agan, Brian K.

AU - Bradley, William P.

AU - Malia, Jennifer

AU - Peel, Sheila A.

AU - Jagodzinski, Linda L.

AU - Weintrob, Amy C.

AU - Ganesan, Anuradha

AU - Bavaro, Mary

AU - Maguire, Jason D.

AU - Landrum, Michael L.

PY - 2014/6/1

Y1 - 2014/6/1

N2 - Background: Understanding the impact of hepatitis B virus (HBV) coinfection on HIV outcomes in the highly active antiretroviral therapy (HAART) era continues to be a critical priority given the high prevalence of coinfection and the potential for impaired immunologic, virologic, and clinical recovery. Methods: Participants from the US Military HIV Natural History Study with an HIV diagnosis on HAART and serologically confirmed HBV infection status at HAART initiation (HI) were classified into 4 HBV infection (HB) groups. HIV virologic, immunologic, and clinical outcomes were evaluated by HB status. Results: Of 2536 HIV-positive HAART recipients, with HBV testing results available to determine HB status in the HI window, HB status at HI was classified as HB negative (n = 1505; 66%), resolved HB (n = 518; 23%), isolated hepatitis B core antigen (n = 139; 6%), or chronic HB (n = 131; 6%). HIV virologic suppression and failure at 6 months or 1 year were not significantly different by HB status. A significantly faster rate of increase in CD4 cell count during the period between 4 and 12 years was observed for chronic HB relative to HB negative. Chronic and resolved HB were associated with an increased risk of AIDS/death compared with HB-negative individuals (chronic HB - hazard ratio = 1.68, 95% confidence interval: 1.05 to 2.68; resolved HB - hazard ratio = 1.61, 95% confidence interval: 1.15 to 2.25). Conclusions: HB status did not have a significant impact on HIV virologic outcomes, however, CD4 cell count reconstitution after HI and the risk of an AIDS event or death after HI may be associated with HB status.

AB - Background: Understanding the impact of hepatitis B virus (HBV) coinfection on HIV outcomes in the highly active antiretroviral therapy (HAART) era continues to be a critical priority given the high prevalence of coinfection and the potential for impaired immunologic, virologic, and clinical recovery. Methods: Participants from the US Military HIV Natural History Study with an HIV diagnosis on HAART and serologically confirmed HBV infection status at HAART initiation (HI) were classified into 4 HBV infection (HB) groups. HIV virologic, immunologic, and clinical outcomes were evaluated by HB status. Results: Of 2536 HIV-positive HAART recipients, with HBV testing results available to determine HB status in the HI window, HB status at HI was classified as HB negative (n = 1505; 66%), resolved HB (n = 518; 23%), isolated hepatitis B core antigen (n = 139; 6%), or chronic HB (n = 131; 6%). HIV virologic suppression and failure at 6 months or 1 year were not significantly different by HB status. A significantly faster rate of increase in CD4 cell count during the period between 4 and 12 years was observed for chronic HB relative to HB negative. Chronic and resolved HB were associated with an increased risk of AIDS/death compared with HB-negative individuals (chronic HB - hazard ratio = 1.68, 95% confidence interval: 1.05 to 2.68; resolved HB - hazard ratio = 1.61, 95% confidence interval: 1.15 to 2.25). Conclusions: HB status did not have a significant impact on HIV virologic outcomes, however, CD4 cell count reconstitution after HI and the risk of an AIDS event or death after HI may be associated with HB status.

KW - HIV

KW - chronic hepatitis B

KW - hepatitis B virus

KW - highly active antiretroviral therapy

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HIV outcomes in hepatitis B virus coinfected individuals on HAART

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