Differential clinical and virologic impact of hepatitis B virus genotypes B and C on HIV-coinfected patients receiving lamivudine-containing highly active antiretroviral therapy
Journal
Clinical Infectious Diseases
Journal Volume
54
Journal Issue
4
Pages
548-555
Date Issued
2012
Author(s)
Abstract
Background. The impact of hepatitis B virus (HBV) genotypes B and C on the clinical, immunologic, and virologic outcomes of human immunodeficiency virus (HIV)-infected patients with chronic HBV infection remains largely unknown. Methods. Between January 1997 and December 2008, we enrolled 96 HIV-infected patients with HBV genotype B coinfection and 49 with genotype C coinfection; the patients were followed prospectively until December 2010. Clinical and immunologic outcomes in the context of HBV genotypes as well as the emergence of HBV DNA mutations conferring lamivudine resistance (rtM204I/V) were determined.Results.The median duration of lamivudine-containing highly active antiretroviral therapy (HAART) was 2.80 years (interquartile range, 1.73-5.92 years). The 2 groups of HIV-infected patients were comparable in age, sex, baseline HIV profiles, and liver function profiles. Compared with HIV-infected patients with HBV genotype C coinfection, those with genotype B coinfection had a higher risk of hepatitis flares (43.8% vs 26.5%; P =. 04), liver disease-related death (9.4% vs 0%; P =. 03), hepatitis B e antigen (HBeAg) seroconversion (61.5% vs 25.0%, P =. 03), and development of lamivudine resistance (31.3% vs 12.2%; P <. 0001). No differences were observed between the 2 groups in terms of the development of hyperbilirubinemia, cirrhosis, or virologic and immunologic responses to HAART. Conclusions. Although therapeutic responses to long-term lamivudine-containing HAART were comparable between HIV-infected patients with HBV genotypes B and C coinfection, patients with genotype B coinfection were more likely to experience acute exacerbations of hepatitis, HBeAg seroconversion, lamivudine resistance, and liver disease-related death than those with genotype C coinfection. ? 2011 The Author.
SDGs
Other Subjects
hepatitis B(e) antigen; lamivudine; virus DNA; adult; article; cohort analysis; death; disease exacerbation; gene mutation; genotype; hepatitis B; Hepatitis B virus; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; hyperbilirubinemia; immunology; liver cirrhosis; major clinical study; male; mixed infection; observational study; priority journal; prospective study; seroconversion; treatment duration; treatment response
Type
journal article