Hepatitis B virus activity in untreated hepatitis B e antigen-negative human immunodeficiency virus-hepatitis B virus co-infected patients from sub-Saharan Africa

Anders Boyd, Menan Gerard Kouamé, Laura Houghtaling, Raoul Moh, Delphine Gabillard, Sarah Maylin, Mariama Abdou Chekaraou, Constance Delaugerre, Xavier Anglaret, Serge Paul Eholié, Christine Danel, Fabien Zoulim, Karine Lacombe

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: In human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infected patients from sub-Saharan Africa with hepatitis B e antigen (HBeAg)-negative status, data are limited on the evolution of HBV activity when antiretroviral treatment (ART) is absent. Methods: A total of 43 HBeAg-negative co-infected patients not indicated for ART (per concomitant World Health Organization recommendations) were followed during participation in a randomized controlled trial in Côte d'Ivoire. Chronic HBeAg-negative phases were classified at yearly visits and defined as 'infection' (HBV DNA ≤10 000 copies/mL and normal alanine aminotransferase [ALT]) or 'hepatitis' (HBV DNA >10 000 copies/mL and/or above normal ALT). Dispersion in HBV DNA and ALT levels during follow-up was assessed using interquartile range (IQR) regression. Results: During a median 25 months (IQR 19-31), 17 (40%) patients consistently had 'infection', 5 (12%) consistently had 'hepatitis' and 21 (48%) fluctuated between phases. Wider dispersion in HBV DNA over time was associated with higher baseline HIV RNA (p=0.02) and higher baseline HBV DNA levels (p=0.008), while wider dispersion in ALT was associated with higher baseline HIV RNA (p<0.001), higher baseline ALT levels (p=0.02) and baseline hepatitis surface antigen >4.0 log10 IU/mL (p=0.02). Conclusions: HBV activity is common with HBeAg-negative status, whose variation is partly linked to HIV replication. Fluctuations in disease phase make it difficult to assess the risk of morbidity and mortality after ART initiation.

Original languageEnglish (US)
Article numbertrz021
Pages (from-to)437-445
Number of pages9
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Volume113
Issue number8
DOIs
StatePublished - Aug 1 2019

Bibliographical note

Funding Information:
Funding: This work was supported by the French Agence Nationale de Recherches sur le SIDA et les hépatites virales (ANRS). A post-doctoral fellowship from the ANRS and Sidaction was awarded to A.B. for some of the work presented in this article.

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Keywords

  • chronic hepatitis B
  • genetic variability
  • HBeAg negative
  • natural history
  • surface gene

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