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Abstract Details
Hepatitis B surface antigen and Hepatitis B RNA changes in HIV/HBV Co-infected participants receiving HBV-active antiretroviral therapy for 144 weeks
AIDS. 2022 Feb 14. doi: 10.1097/QAD.0000000000003193. Online ahead of print.
Claudia Hawkins1, Minhee Kang, Debika Bhattacharya, Gavin Cloherty, Mary Kuhns, Roy Matining, Chloe Thio, Wadzanai Samaneka, Lameck Chinula, Nyirenda Mulinda, Sharlaa Badal-Faesen, Patcharaphan Sugandhavesa, Javier Lama, Simani Gaseitsiwe, Vera Holzmayer, Mark Anderson, Robert Murphy, Marion Peters
Author information
Department of Medicine, Feinberg School of Medicine, Northwestern University CRS Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA David Geffen School of Medicine, Division of Infectious Diseases, University of California, Los Angeles (UCLA) Infectious Diseases Research, Diagnostics, Division, Abbott Laboratories, Abbott Park, IL Johns Hopkins University, Department of Medicine University of Zimbabwe Clinical Trials Research Centre, Zimbabwe UNC Project Malawi CRS, UNC Department of Obstetrics and Gynecology's Division of Global Women's Health, NC, USA Malawi College of Medicine- Johns Hopkins Research Project CRS Clinical HIV Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand HIV/AIDS and Infectious Disease CTU Asociacion Civil Impacta Salud y Educacion, IMPACTA, Peru CTU Botswana Harvard School of Public Health AIDS Initiative Partnership CRS.
Abstract
Introduction: With advances in HBV therapies, there is a need to identify serum biomarkers that assess the HBV cccDNA reservoir and predict functional cure in HIV/HBV co-infection.
Methods: In this retrospective study combining samples from HIV/HBV co-infected participants enrolled in two ACTG interventional trials, proportions achieving HBsAg < 0.05 log10 IU/mL and HBV RNA < log10 1.65 U/mL or not detected (LLoQ/NEG) in response to DUAL [tenofovir TDF+emtricitabine (FTC)) vs. MONO (FTC or lamivudine (3TC)] HBV-active ART, were measured. Predictors of qHBsAg < 0.05 log10 IU/mL were evaluated in logistic regression models.
Results: There were 88 participants [58% female, median age 34; 47 on DUAL vs. 41 on MONO HBV-active ART]. 21% achieved HBsAg < 0.05 log10 IU/mL (30% DUAL vs. 10% MONO). Time to HBsAg < 0.05 log10 IU/mL was lower (p = 0.02) and the odds of achieving HBsAg < 0.05 log10 IU/mL were higher (p = 0.07) in DUAL participants. HBV RNA became <LLoQ/NEG in 47% (DUAL 60% vs. MONO 33%). qHBsAg < 3 log10 IU/mL was the strongest predictor of HBsAg < 0.05 log10 IU/mL.
Conclusion: This study supports current recommendations of TDF based DUAL-HBV active ART for initial use in HIV/HBV co-infection. HBV RNA could be a useful marker of treatment response in HIV/HBV co-infected patients on HBV-active ART.