Predictors of HBeAg status and hepatitis B viraemia in HIV-infected patients with chronic hepatitis B in the HAART era in Brazil

Autor(es)

Mendes-Correa, Maria Cassia ^{[1, 2]} ; Pinho, Joao R. R. ^{[3, 4]} ; Gomes-Gouvea, Michele S. ^{[3, 4]} ; da Silva, Adriana C. ^[1] ; Guastini, Cristina F. ^[1] ; Martins, Luiz G. ^[5] ; Leite, Andrea G. ^{[1, 2]} ; Silva, Mariliza H. ^[5] ; Gianini, Reinaldo J. ^[6] ; Uip, David E. ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Dept Infect Dis, Sao Paulo - Brazil

^[2] ABC Med Sch, Infect Dis Res Unit, Santo Andre - Brazil

^[3] Univ Sao Paulo, Sch Med, Dept Gastroenterol, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Med, Dept Trop Med, Sao Paulo - Brazil

^[5] AIDS Outpatient Clin, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Sch Med, Lab Med Invest Epidemiol & Stat, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: BMC INFECTIOUS DISEASES; v. 11, SEP 20 2011.
• Citações Web of Science: 4

Resumo

Background: HBV-HIV co-infection is associated with an increased liver-related morbidity and mortality. However, little is known about the natural history of chronic hepatitis B in HIV-infected individuals under highly active antiretroviral therapy (HAART) receiving at least one of the two drugs that also affect HBV (TDF and LAM). Information about HBeAg status and HBV viremia in HIV/HBV co-infected patients is scarce. The objective of this study was to search for clinical and virological variables associated with HBeAg status and HBV viremia in patients of an HIV/HBV co-infected cohort. Methods: A retrospective cross-sectional study was performed, of HBsAg-positive HIV-infected patients in treatment between 1994 and 2007 in two AIDS outpatient clinics located in the Sao Paulo metropolitan area, Brazil. The baseline data were age, sex, CD4 T+ cell count, ALT level, HIV and HBV viral load, HBV genotype, and duration of antiretroviral use. The variables associated to HBeAg status and HBV viremia were assessed using logistic regression. Results: A total of 86 HBsAg patients were included in the study. Of these, 48 (56%) were using combination therapy that included lamivudine (LAM) and tenofovir (TDF), 31 (36%) were using LAM monotherapy, and 7 patients had no previous use of either one. Duration of use of TDF and LAM varied from 4 to 21 and 7 to 144 months, respectively. A total of 42 (48. 9%) patients were HBeAg positive and 44 (51. 1%) were HBeAg negative. The multivariate analysis revealed that the use of TDF for longer than 12 months was associated with undetectable HBV DNA viral load (serum HBV DNA level < 60 UI/ml) (p = 0. 047). HBeAg positivity was associated with HBV DNA > 60 UI/ml (p = 0. 001) and ALT levels above normality (p = 0. 038). Conclusion: Prolonged use of TDF containing HAART is associated with undetectable HBV DNA viral load. HBeAg positivity is associated with HBV viremia and increased ALT levels. (AU)

• Processo FAPESP: 08/57146-9 - Estudo da distribuição genotípica e de mutações na região da polimerase no genoma do vírus da Hepatite B e de pacientes cronicamente infectados atendidos na região do Grande ABC Paulista
• Beneficiário: Maria Cássia Jacintho Mendes Corrêa
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 06/54332-0 - Estudo da distribuição genotípica e de mutações no genoma do vírus da Hepatite B, em pacientes co-infectados pelos vírus da Hepatite B e HIV na Casa da AIDS do Hospital das Clínicas da Faculdade de Medicina da USP
• Beneficiário: Maria Cássia Jacintho Mendes Corrêa
• Modalidade de apoio: Auxílio à Pesquisa - Regular