Hepatitis B virus seroprevalence among HIV-infected patients receiving combination antiretroviral therapy three decades after universal neonatal hepatitis B immunization program in Taiwan
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
54
Journal Issue
2
Pages
228-237
Date Issued
2021
Author(s)
Lin J.-J.
Tang H.-J.
Lin S.-P.
Lee Y.-C.
Liu C.-E.
Wang N.-C.
Li C.-W.
Ko W.-C.
Yang H.-J.
Lee Y.-T.
Taiwan HIV Study Group
Abstract
Background/purpose: This multicenter study aimed to evaluate the seroprevalence of hepatitis B virus (HBV) and the use of combination antiretroviral therapy (cART) among patients receiving HIV care in Taiwan. Methods: We retrospectively reviewed the medical records of HIV-infected adult patients who initiated cART at 11 designated hospitals in Taiwan between 2012 and 2016. The clinical information collected included serological profiles on HBV, hepatitis C virus (HCV), and syphilis, plasma HIV RNA load, nadir CD4 cell count, and antiretrovirals with activity against both HBV and HIV (tenofovir disoproxil fumarate [TDF], lamivudine [LAM], and emtricitabine [FTC]). Results: We analyzed 1800 HIV-infected patients; 1742 (96.8%) were male and 794 (44.1%) were born after July, 1986, when nationwide universal neonatal HBV vaccination was implemented. HBsAg positive results were 11.6% (209/1800), which decreased significantly from 18.1% (182/1006) in those born before July 1986 to 3.4% (27/794) in those born after. In multivariable analysis, HBsAg positivity was significantly associated with age (adjusted odds ratio [aOR] 1.06, 95% confidence interval [CI] 1.05–1.08), CD4≧200 cells/μL (aOR 0.73, 95% CI 0.53–0.99), and HCV seropositivity (aOR 1.62, 95% CI 1.06–2.50). Of 209 HBV/HIV-coinfected patients, 31.1% started cART containing only LAM with anti-HBV activity, while 68.9% started cART containing TDF plus LAM or coformulated TDF/FTC. Conclusions: The overall prevalence of HBV/HIV coinfection remained high among HIV-infected patients in Taiwan. Despite recommendations of the HIV treatment guidelines for the management of HBV infection, a substantial proportion of HIV/HBV-coinfected patients received cART containing only LAM for HBV infection. ? 2019
SDGs
Other Subjects
abacavir plus dolutegravir plus lamivudine; efavirenz plus emtricitabine plus tenofovir disoproxil; emtricitabine plus rilpivirine plus tenofovir disoproxil; emtricitabine plus tenofovir disoproxil; hepatitis B core antigen; hepatitis B surface antibody; hepatitis B surface antigen; hepatitis C antibody; lamivudine plus tenofovir disoproxil; nonnucleoside reverse transcriptase inhibitor; reaginic antibody; RNA directed DNA polymerase inhibitor; antiretrovirus agent; biological marker; lamivudine; tenofovir; adult; antibody titer; antiretroviral therapy; Article; CD4 lymphocyte count; cohort analysis; coinfection; controlled study; female; groups by age; hepatitis B; Hepatitis B virus; Hepatitis C virus; heterosexuality; high risk population; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; injection drug user; laboratory test; major clinical study; male; medical record review; men who have sex with men; multicenter study; newborn hepatitis; practice guideline; preventive health service; retrospective study; serology; seroprevalence; sexually transmitted disease; syphilis; Taiwan; vaccination; virus load; coinfection; complication; hemochromatosis; hepatitis B; Human immunodeficiency virus infection; immunology; seroepidemiology; young adult; Adult; Anti-Retroviral Agents; Biomarkers; CD4 Lymphocyte Count; Coinfection; Female; Hemochromatosis; Hepatitis B; Hepatitis B virus; HIV Infections; Humans; Immunization Programs; Lamivudine; Male; Retrospective Studies; Seroepidemiologic Studies; Syphilis; Taiwan; Tenofovir; Young Adult
Publisher
Elsevier Ltd
Type
journal article