Association of Hepatitis B Core-Related Antigen and Antihepatitis B Core Antibody With Liver Fibrosis Evolution in Human Immunodeficiency Virus-Hepatitis B Virus Coinfected Patients During Treatment With Tenofovir

Abstract Background Quantitative hepatitis B core-related antigen (qHBcrAg) or antihepatitis B core antibody (qAnti-HBc) could be useful in monitoring liver fibrosis evolution during chronic hepatitis B virus (HBV) infection, yet it has not been assessed in human immunodeficiency virus (HIV)-HBV-coinfected patients undergoing treatment with tenofovir (TDF). Methods One hundred fifty-four HIV-HBV-infected patients initiating a TDF-containing antiretroviral regimen were prospectively followed. The qHBcrAg and qAnti-HBc and liver fibrosis assessment were collected every 6–12 months during TDF. Hazard ratios (HRs) assessing the association between qHBcrAg/qAnti-HBc and transitions from none/mild/significant fibrosis to advanced fibrosis/cirrhosis (progression) and from advanced fibrosis/cirrhosis to none/mild/significant fibrosis (regression) were estimated using a time-homogeneous Markov model. Results At baseline, advanced liver fibrosis/cirrhosis was observed in 40 (26%) patients. During a median follow-up of 48 months (interquartile range, 31–90), 38 transitions of progression (IR = 7/100 person-years) and 34 transitions of regression (IR = 6/100 person-years) were observed. Baseline levels of qHBcrAg and qAnti-HBc were not associated with liver fibrosis progression (adjusted-HR per log10 U/mL = 1.07, 95% confidence interval [CI] = 0.93–1.24; adjusted-HR per log10 Paul-Ehrlich-Institute [PEI] U/mL = 0.85, 95% CI = 0.70–1.04, respectively) or regression (adjusted-HR per log10 U/mL = 1.17, 95% CI = 0.95–1.46; adjusted-HR per log10 PEI U/mL = 0.97, 95% CI = 0.78–1.22, respectively) after adjusting for age, gender, duration of antiretroviral therapy, protease inhibitor-containing antiretroviral therapy, and CD4+/CD8+ ratio. Nevertheless, changes from the previous visit of qAnti-HBc levels were associated with liver fibrosis regression (adjusted-HR per log10 PEIU/mL change = 5.46, 95% CI = 1.56–19.16). Conclusions Baseline qHBcrAg and qAnti-HBc levels are not associated with liver fibrosis evolution in TDF-treated HIV-HBV coinfected patients. The link between changes in qAnti-HBc levels during follow-up and liver fibrosis regression merits further study.

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A Case of Hepatitis B Virus/human Immunodeficiency Virus Coinfection in a Patient Who Achived Hepatitis B Surface Antigen Seroclearance After Interferon Therapy Followed by Antiretroviral Therapy without Developing Immune Reconstitution Inflammatory Syndrome

Kansenshogaku zasshi ◽

10.11150/kansenshogakuzasshi.86.763 ◽

2012 ◽

Vol 86 (6) ◽

pp. 763-767 ◽

Cited By ~ 2

Author(s):

Fujiko MITSUMOTO ◽

Masayuki MURATA ◽

Hiroaki IKEZAKI ◽

Eiichi OGAWA ◽

Hiroaki TANIAI ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Antiretroviral Therapy ◽

Hepatitis B ◽

Immune Reconstitution ◽

Interferon Therapy ◽

Hepatitis B Surface Antigen ◽

B Virus ◽

Immunodeficiency Virus ◽

Inflammatory Syndrome

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Diagnostic accuracy of the Coopscore© to predict liver fibrosis in human immunodeficiency virus/hepatitis B virus co-infection

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/0004563217707979 ◽

2017 ◽

Vol 55 (2) ◽

pp. 236-243 ◽

Cited By ~ 1

Author(s):

Ludmia Taibi ◽

Anders Boyd ◽

Nelly Bosselut ◽

Julie Bottero ◽

Jérôme Guéchot ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Liver Fibrosis ◽

Hepatitis B ◽

Diagnostic Value ◽

Virus Hepatitis ◽

Significant Fibrosis ◽

B Virus ◽

Immunodeficiency Virus ◽

Fibrosis Staging

Background Non-invasive methods for assessing liver fibrosis are increasingly used as an alternative to liver biopsy. Recently, a score-based biochemical blood test (Coopscore©) was developed in a cohort of patients chronically infected with hepatitis C virus, showing higher diagnostic performances than Fibrometer®, Fibrotest®, Hepascore® and Fibroscan™. Here, we assess its performance in patients co-infected with the human immunodeficiency virus and hepatitis B virus. Methods Ninety-seven human immunodeficiency virus/hepatitis B virus co-infected patients with liver biopsies were included from a previously described cohort. Histological fibrosis staging using METAVIR criteria was used as the reference. Coopscore©, Fibrotest®, Fibrometer®, Hepascore® and Zeng score were computed and compared with the Coopscore© using the Obuchowski index and area under the receiving operator characteristic curves. Results The distribution of liver fibrosis levels was as follows: F0–F1 ( n = 42), F2 ( n = 25), F3 ( n = 15) and F4 ( n = 15). The Obuchowski index was higher for Coopscore© (0.774) than Fibrometer® (0.668), Hepascore® (0.690) and Zeng scores (0.704) ( P < 0.05), reflecting a better ability to discriminate between fibrosis stages. Similarly, when predicting significant fibrosis (≥F2), the AUROC was significantly greater for the Coopscore© (0.836) than the Hepascore® (0.727) and Zeng scores (0.746), but not for the Fibrotest® (0.778, P = 0.14) or Fibrometer® (0.790, P = 0.19). The Coopscore© did not show a higher capacity than other scores to predict advanced fibrosis (≥F3) or cirrhosis (F4). Conclusions This study supports the diagnostic value of the Coospcore© in fibrosis staging among human immunodeficiency virus/hepatitis B virus co-infected patients, especially to predict significant fibrosis.

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Acute clinical hepatitis by immune restoration in a human immunodeficiency virus/hepatitis B virus co-infected patient receiving antiretroviral therapy

European Journal of Gastroenterology & Hepatology ◽

10.1097/00042737-200301000-00017 ◽

2003 ◽

Vol 15 (1) ◽

pp. 95-97 ◽

Cited By ~ 10

Author(s):

Isabelle Rouanet ◽

Hélène Peyrière ◽

Jean-Marc Mauboussin ◽

Nicolas Terrail ◽

Denis Vincent

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Antiretroviral Therapy ◽

Hepatitis B ◽

Infected Patient ◽

Virus Hepatitis ◽

Immune Restoration ◽

B Virus ◽

Immunodeficiency Virus

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Hepatitis B Virus (HBV) Genotype Mixtures, Viral Load, and Liver Damage in HBV Patients Co-infected With Human Immunodeficiency Virus

Frontiers in Microbiology ◽

10.3389/fmicb.2021.640889 ◽

2021 ◽

Vol 12 ◽

Author(s):

Alexis Jose-Abrego ◽

Sonia Roman ◽

João Renato Rebello Pinho ◽

Vanessa Fusco Duarte de Castro ◽

Arturo Panduro

Keyword(s):

Human Immunodeficiency Virus ◽

Viral Load ◽

Hepatitis B Virus ◽

Liver Fibrosis ◽

Hepatitis B ◽

Hbv Genotypes ◽

Spearman's Rho ◽

Spearman’S Rho ◽

B Virus ◽

Immunodeficiency Virus

Hepatitis B virus (HBV) co-infection is possible in patients who are positive for human immunodeficiency virus (HIV) since both share similar transmission routes. Furthermore, through the continuous risk of exposure, they potentially can be infected by mixtures of distinct HBV genotypes which can result in the presence of two or more genotypes in a single patient. This study aimed to specify the frequency of mixtures of HBV genotypes and their potential clinic importance in HIV-infected Mexican patients. HBV infection was assessed by serological testing and molecular diagnostics. HBV mixtures were detected by multiplex PCR and DNA sequencing. Liver fibrosis was evaluated using transitional elastography, the Aspartate aminotransferase to Platelets Ratio Index score, and Fibrosis-4 score. Among 228 HIV-infected patients, 67 were positive for HBsAg. In 25 HBV/HIV co-infected patients, 44 HBV genotypes were found: H (50.0%, 22/44), G (22.7%, 10/44), D (15.9%, 6/44), A (9.1%, 4/44), and F (2.3%, 1/44). Among these, 44.0% (11/25) were single genotype, 36.0% (9/25) were dual and 20.0% (5/25) were triple genotype. The most frequent dual combination was G/H (44.4%, 4/9), while triple-mixtures were H/G/D (60.0%, 3/5). The increase in the number of genotypes correlated positively with age (Spearman’s Rho = 0.53, p = 0.0069) and negatively with platelet levels (Spearman’s Rho = − 0.416, p = 0.039). HBV viral load was higher in triply-infected than dually infected (31623.0 IU/mL vs. 1479.0 IU/mL, p = 0.029) patients. Triple-mixed infection was associated with significant liver fibrosis (OR = 15.0 95%CI = 1.29 – 174.38, p = 0.027). In conclusion, infection with mixtures of HBV genotypes is frequent in HIV patients causing significant hepatic fibrosis related to high viral load, especially in triple genotype mixtures.

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Highly active antiretroviral therapy improved persistent lamivudine-resistant viremia in acute hepatitis B virus genotype Ae infection with coinfection of human immunodeficiency virus

Hepatology Research ◽

10.1111/j.1872-034x.2009.00570.x ◽

2010 ◽

Vol 40 (2) ◽

pp. 229-235 ◽

Cited By ~ 1

Author(s):

Mashu Aizawa ◽

Akihito Tsubota ◽

Kiyotaka Fujise ◽

Tetsuro Kato ◽

Mitsuo Sakamoto ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Antiretroviral Therapy ◽

Hepatitis B ◽

Highly Active Antiretroviral Therapy ◽

Virus Genotype ◽

Highly Active ◽

B Virus ◽

Immunodeficiency Virus ◽

Acute Hepatitis B

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The kinetics of the hepatitis B surface antigen level after the initiation of antiretroviral therapy for hepatitis B virus and human immunodeficiency virus coinfected patients

Journal of Infection and Chemotherapy ◽

10.1016/j.jiac.2014.12.003 ◽

2015 ◽

Vol 21 (4) ◽

pp. 264-271 ◽

Cited By ~ 3

Author(s):

Fujiko Mitsumoto ◽

Masayuki Murata ◽

Kazuya Ura ◽

Koji Takayama ◽

Satoshi Hiramine ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Antiretroviral Therapy ◽

Hepatitis B ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Antigen Level ◽

B Virus ◽

Immunodeficiency Virus ◽

Kinetics Of

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Hepatitis B virus genotype G and liver fibrosis progression in chronic hepatitis B and human immunodeficiency virus coinfection

Journal of Medical Virology ◽

10.1002/jmv.25360 ◽

2018 ◽

Vol 91 (4) ◽

pp. 630-641 ◽

Cited By ~ 4

Author(s):

Vincenzo Malagnino ◽

Julie Bottero ◽

Patrick Miailhes ◽

Caroline Lascoux-Combe ◽

Pierre-Marie Girard ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Chronic Hepatitis ◽

Hepatitis B Virus ◽

Liver Fibrosis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Virus Genotype ◽

Fibrosis Progression ◽

B Virus ◽

Immunodeficiency Virus

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High Rates of Hepatitis B Virus (HBV) Functional Cure Among Human Immunodeficiency Virus-HBV Coinfected Patients on Antiretroviral Therapy in Zambia

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz450 ◽

2019 ◽

Vol 221 (2) ◽

pp. 218-222 ◽

Cited By ~ 3

Author(s):

Belinda V Chihota ◽

Gilles Wandeler ◽

Roma Chilengi ◽

Lloyd Mulenga ◽

Raymond T Chung ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Antiretroviral Therapy ◽

Hepatitis B ◽

Hepatitis B Surface Antigen ◽

Multivariable Analysis ◽

Cd4 Count ◽

Functional Cure ◽

B Virus ◽

Immunodeficiency Virus

Abstract Among 284 human immunodeficiency virus (HIV)-hepatitis B virus (HBV) coinfected adults starting tenofovir-based antiretroviral therapy (ART) in Zambia, median baseline CD4+ count was 202 cells/mm3 and 41.6% were hepatitis B e-antigen positive. Within 2 years of therapy, 29 (10.2%) participants experienced HBV functional cure (confirmed loss of hepatitis B surface antigen). In multivariable analysis, baseline CD4 count <350 cells/mm3, female sex, and lower baseline HBV deoxyribonucleic acid were associated with increased odds of functional cure. Immune recovery during HIV-HBV treatment with ART may drive higher rates of functional cure than during HBV monoinfection treatment. Understanding the mechanisms underlying this phenomenon could inform immunomodulatory therapies for HBV cure.

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Liver Fibrosis Regression Measured by Transient Elastography in Human Immunodeficiency Virus (HIV)-Hepatitis B Virus (HBV)-Coinfected Individuals on Long-Term HBV-Active Combination Antiretroviral Therapy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw035 ◽

2016 ◽

Vol 3 (1) ◽

Cited By ~ 8

Author(s):

Jennifer Audsley ◽

Christopher Robson ◽

Stacey Aitchison ◽

Gail V. Matthews ◽

David Iser ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Liver Fibrosis ◽

Transient Elastography ◽

Alanine Transaminase ◽

Combination Antiretroviral Therapy ◽

Advanced Fibrosis ◽

Factors Associated ◽

B Virus ◽

Immunodeficiency Virus ◽

Fibrosis Regression

Abstract Background. Advanced fibrosis occurs more commonly in human immunodeficiency virus (HIV)-hepatitis B virus (HBV) coinfected individuals; therefore, fibrosis monitoring is important in this population. However, transient elastography (TE) data in HIV-HBV coinfection are lacking. We aimed to assess liver fibrosis using TE in a cross-sectional study of HIV-HBV coinfected individuals receiving combination HBV-active (lamivudine and/or tenofovir/tenofovir-emtricitabine) antiretroviral therapy, identify factors associated with advanced fibrosis, and examine change in fibrosis in those with >1 TE assessment. Methods. We assessed liver fibrosis in 70 HIV-HBV coinfected individuals on HBV-active combination antiretroviral therapy (cART). Change in fibrosis over time was examined in a subset with more than 1 TE result (n = 49). Clinical and laboratory variables at the time of the first TE were collected, and associations with advanced fibrosis (≥F3, Metavir scoring system) and fibrosis regression (of least 1 stage) were examined. Results. The majority of the cohort (64%) had mild to moderate fibrosis at the time of the first TE, and we identified alanine transaminase, platelets, and detectable HIV ribonucleic acid as associated with advanced liver fibrosis. Alanine transaminase and platelets remained independently advanced in multivariate modeling. More than 28% of those with >1 TE subsequently showed liver fibrosis regression, and higher baseline HBV deoxyribonucleic acid was associated with regression. Prevalence of advanced fibrosis (≥F3) decreased 12.3% (32.7%–20.4%) over a median of 31 months. Conclusions. The observed fibrosis regression in this group supports the beneficial effects of cART on liver stiffness. It would be important to study a larger group of individuals with more advanced fibrosis to more definitively assess factors associated with liver fibrosis regression.

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