scholarly journals Prevalence and Outcomes of Hepatitis B Coinfection and Associated Liver Disease Among Antiretroviral Therapy-Naive Individuals in a Rural Tanzanian Human Immunodeficiency Virus Cohort

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Adrià Ramírez-Mena ◽  
Tracy R. Glass ◽  
Annja Winter ◽  
Namvua Kimera ◽  
Alex Ntamatungiro ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Hepatic Fibrosis ◽  
Sub Saharan Africa ◽  
Significant Fibrosis ◽  
Art Initiation ◽  
Immunodeficiency Virus ◽  
Apri Score ◽  
Significant Liver Fibrosis

Abstract Background.  We evaluated the prevalence of chronic hepatitis B virus (HBV) infection and liver fibrosis/cirrhosis in human immunodeficiency virus (HIV)-infected individuals enrolled in a rural Tanzanian prospective cohort and assessed hepatic fibrosis progression 12–24 months after antiretroviral treatment (ART) initiation. Methods.  All ART-naive HIV-infected adults ≥15-year-old enrolled in the Kilombero and Ulanga Antiretroviral Cohort who started ART between 2005 and 2015 were included. Pre-ART factors associated with significant liver fibrosis (aspartate aminotransferase-to-platelet ratio index [APRI] >1.5) and cirrhosis (APRI > 2.0) were identified using logistic regression. Results.  Of 3097 individuals screened, 227 (7.3%; 95% CI, 6.4–8.2) were hepatitis B surface antigen (HBsAg) positive. Before ART initiation, 9.1% individuals had significant liver fibrosis and 5.3% had cirrhosis. Human immunodeficiency virus/HBV-coinfected individuals were more likely to have an APRI score indicating significant fibrosis (14.2% vs 8.7%, P = .03) and cirrhosis (9.2% vs 4.9%, P = .03) than HBV-uninfected patients. CD4 cell count <200 cell/μL and alcohol consumption were independently associated with pre-ART APRI score, indicating significant fibrosis and cirrhosis in multivariable analyses. Among individuals with elevated APRI measurements pre- and 12–24 months post-ART initiation, 53 of 57 (93.0%) of HIV-monoinfected and 4 of 5 (80.0%) of HIV/HBV-coinfected had a regression to APRI < 1.5. Conclusions.  Hepatic fibrosis and cirrhosis were common in our cohort, especially among HIV/HBV-coinfected individuals. The APRI improved in most patients. Pre-ART HBsAg screening and early onset of tenofovir-based ART for HIV/HBV-coinfection should be prioritized in sub-Saharan Africa.

scholarly journals High Prevalence of Liver Fibrosis in Patients with Human Immunodeficiency Virus Monoinfection and Human Immunodeficiency Virus Hepatitis-B Co-infection as Assessed by Shear Wave Elastography: Study at a Teaching Hospital in Kenya

2016 ◽  
Vol 6 ◽  
pp. 22 ◽  
Author(s):  
Samuel Nguku Gitau ◽  
Sudhir Vinayak ◽  
Micah Silaba ◽  
Rodney Adam ◽  
Reena Shah
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Sub Saharan Africa ◽  
Rapid Progression ◽  
Immunodeficiency Virus ◽  
High Prevalence ◽  
Apri Score

Objectives: The aim of this study was to determine the prevalence of liver fibrosis in patients with human immunodeficiency virus (HIV) monoinfection versus those with HIV hepatitis-B virus (HBV) co-infection as assessed with shear wave elastography (SWE) in a tertiary sub-Saharan Africa hospital. Materials and Methods: A total of 105 consecutive patients, 70 with HIV monoinfection and 35 with HIV-HBV co-infection, had liver elastography obtained using SWE to assess for the presence of liver fibrosis the cutoff of which was 5.6 kPa. Assessment of aspartate aminotransferase-to-platelet ratio index (APRI) score (a noninvasive serum biomarker of liver fibrosis) in these patients was also done. Results: The prevalence of liver fibrosis was significantly higher (P < 0.0001) in patients with HIV-HBV co-infection, 25.7%, compared to those with HIV monoinfection, 7.1%. APRI score was greater in patients with HIV-HBV co-infection than those with HIV monoinfection. HIV co-infection with HBV accelerates progression to liver fibrosis. Association of a low cluster of differentiation 4 (CD-4) count with advanced fibrosis supports earlier starting of antiretroviral therapy to prevent rapid progression of liver disease in HIV-positive patients. Conclusion: In view of the high prevalence of liver fibrosis in patients with HIV-HBV co-infection, regular monitoring of the disease progression is recommended.

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

2017 ◽  
Vol 55 (2) ◽  
pp. 236-243 ◽  
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.

scholarly journals Exposure to previous cART is associated with significant liver fibrosis and cirrhosis in human immunodeficiency virus-infected patients

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0191118 ◽  
Author(s):  
Evrim Anadol ◽  
Kristina Lust ◽  
Christoph Boesecke ◽  
Carolynne Schwarze-Zander ◽  
Raphael Mohr ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Fibrosis ◽  
Immunodeficiency Virus ◽  
Significant Liver Fibrosis

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

2019 ◽  
Vol 113 (8) ◽  
pp. 437-445
Author(s):  
Anders Boyd ◽  
Menan Gerard Kouamé ◽  
Laura Houghtaling ◽  
Raoul Moh ◽  
Delphine Gabillard ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hbv Dna ◽  
Sub Saharan Africa ◽  
Hepatitis B E Antigen ◽  
Hiv Rna ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
Sub Saharan

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.

scholarly journals 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

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Romuald Cruchet ◽  
Lorenza N C Dezanet ◽  
Sarah Maylin ◽  
Audrey Gabassi ◽  
Hayette Rougier ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis B Virus ◽  
Antiretroviral Therapy ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Advanced Fibrosis ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
Fibrosis Regression

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.

Global Burden of Hepatitis B Infection in People Living With Human Immunodeficiency Virus: A Systematic Review and Meta-analysis

2019 ◽  
Vol 71 (11) ◽  
pp. 2799-2806 ◽  
Author(s):  
Steve Leumi ◽  
Jean Joel Bigna ◽  
Marie A Amougou ◽  
Anderson Ngouo ◽  
Ulrich Flore Nyaga ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis B ◽  
Meta Analysis ◽  
Hiv Prevalence ◽  
Hbv Infection ◽  
Sub Saharan Africa ◽  
Global Burden ◽  
Pool Data ◽  
The Pacific ◽  
Immunodeficiency Virus

Abstract Background This meta-analysis was conducted to estimate the global burden of hepatitis B virus (HBV) infection in people living with human immunodeficiency virus (PLWH). Methods We searched multiple databases for studies published between January 1990 and December 2017. HBV infection (hepatitis B surface antigen) was diagnosed with serological assays. A random-effects meta-analysis served to pool data. Results We included 358 studies (834 544 PLWH from 87 countries). The pooled prevalence of HBV infection was 8.4% (95% confidence interval [CI], 7.9%–8.8%), among which 26.8% (95% CI, 22.0%–31.9%) was positive to hepatitis B e antigen. HBV prevalence (with 95% CIs) differed according to region: West and Central Africa, 12.4% (11.0%–13.8%); Middle East and North Africa, 9.9% (6.0%–14.6%); Asia and the Pacific, 9.8% (8.7%–11.0%); Eastern and Southern Africa, 7.4% (6.4%–8.4%); Western and Central Europe and North America, 6.0% (5.5%–6.7%); and Latin America and the Caribbean, 5.1% (4.2%–6.2%) (P &lt; .0001). The prevalence decreased from 10.4% in low-developed to 6.6% in highly developed countries (P &lt; .0001) and increased from 7.3% in countries with HIV prevalence ≤1% to 9.7% in countries with HIV prevalence &gt;1% (P &lt; .0001). Globally, we estimated that there were 3 136 500 (95% CI, 2 952 000–3 284 100) cases of HBV in PLWH, with 73.8% of estimated regional cases from sub-Saharan Africa and 17.1% from Asia and the Pacific. Conclusions This study suggests a high burden of HBV infection in PLWH, with disparities according to region, level of development, and country HIV prevalence.

scholarly journals Tobacco Smoking Is Not Associated With Accelerated Liver Disease in Human Immunodeficiency Virus-Hepatitis C Coinfection: A Longitudinal Cohort Analysis

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Cecilia T. Costiniuk ◽  
Laurence Brunet ◽  
Kathleen C. Rollet-Kurhajec ◽  
Curtis L. Cooper ◽  
Sharon L. Walmsley ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Disease ◽  
Longitudinal Study ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Tobacco Smoking ◽  
Cohort Analysis ◽  
Tobacco Exposure ◽  
Immunodeficiency Virus ◽  
Significant Liver Fibrosis

Abstract Background.  Tobacco smoking has been shown to be an independent risk factor for liver fibrosis in hepatitis C virus (HCV) infection in some cross-sectional studies. No longitudinal study has confirmed this relationship, and the effect of tobacco exposure on liver fibrosis in human immunodeficiency virus (HIV)-HCV coinfected individuals is unknown. Methods.  The study population consisted of participants from the Canadian Co-infection Cohort study (CTN 222), a multicenter longitudinal study of HIV-HCV coinfected individuals from 2003 to 2014. Data were analyzed for all participants who did not have significant fibrosis or end-stage liver disease (ESLD) at baseline. The association between time-updated tobacco exposure (ever vs nonsmokers and pack-years) and progression to significant liver fibrosis (defined as an aspartate-to-platelet ratio index [APRI] ≥1.5) or ESLD was assessed by pooled logistic regression. Results.  Of 1072 participants included in the study, 978 (91%) had ever smoked, 817 (76%) were current smokers, and 161 (15%) were previous smokers. Tobacco exposure was not associated with accelerated progression to significant liver fibrosis nor with ESLD when comparing ever vs never smokers (odds ratio [OR] = 1.06, 95% confidence interval [CI], 0.43–1.69 and OR = 1.20, 95% CI, 0.21–2.18, respectively) or increases in pack-years smoked (OR = 1.05, 95% CI, 0.97–1.14 and OR = 0.94, 95% CI, 0.83–1.05, respectively). Both time-updated alcohol use in the previous 6 months and presence of detectable HCV ribonucleic acid were associated with APRI score ≥1.5. Conclusions.  Tobacco exposure does not appear to be associated with accelerated progression of liver disease in this prospective study of HIV-HCV coinfected individuals.

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

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.

scholarly journals Seroprevalência do Anticorpo do Vírus na Hepatite A em Viajantes Portugueses: Um Novo Paradigma

2017 ◽  
Vol 30 (7-8) ◽  
pp. 534
Author(s):  
Sónia Rocha ◽  
Sandra Tejo ◽  
Eugénia Ferreira ◽  
Luís Trindade ◽  
Eduardo Rabadão ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Hepatitis B ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Age Groups ◽  
Sub Saharan Africa ◽  
Immunodeficiency Virus

Introduction: In Portugal, the prevalence of hepatitis A virus infection has decreased in the past decades, especially in young adults. The aim of this study was to detect the prevalence of antibody to hepatitis A virus in a population observed in our Travel Clinic.Material and Methods: Antibodies against hepatitis A, hepatitis B, hepatitis C and human immunodeficiency virus were tested using standard enzyme immunoassay in patients older than 18. The exclusion criteria were: prior vaccination for hepatitis A virus, previous diagnosis of infection with hepatitis B virus, hepatitis C virus and/or human immunodeficiency virus, foreign travelers and long-term expatriates. We applied an epidemiological survey and data was statistically analyzed with SPSS® 18.0.Results: In the 665 travelers studied, natural immunity to hepatitis A virus was present in 57.6% (n = 383). They were stratified into 8 age groups and for each one hepatitis A immunity was clarified: 5.0% (n = 1) in 18 - 25 years, 32.3% (n = 21) in 26 - 30 years, 40.9% (n = 47) in 31 - 35 years, 45.8% (n = 54) in 36 - 40 years, 68.7% (n = 79) in 41 - 45 years, 70.1% (n = 68) in 46 - 50 years, 80.8% (n = 63) in 51 - 55 years and 87.7% (n = 50) over 56 years old. In those who accepted further screening, positivity for hepatitis B core antibody was found in 0.6% (n = 3) travelers, hepatitis C virus infection in 1.1% (n = 6) and human immunodeficiency virus infection in 0.5% (n = 3) whose previous status was unknown. The most frequent travel destination was sub-Saharan Africa (72.6%; n = 483).Discussion: We found 49.1% (n = 260) travelers under 50 years old susceptible to hepatitis A virus infection and for those between 40 and 50 years, 30.7% (n = 65) still need vaccine protection.Conclusion: Across age groups there is a trend towards lower prevalence of hepatitis A virus antibody, in particular among youngsters, when compared with older Portuguese studies.

Sign in / Sign up

Export Citation Format

Share Document