Hepatitis B virus clinical and virologic characteristics in an HIV perinatal transmission study in sub-Saharan Africa.

Autor: Bhattacharya D; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Guo R; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Tseng CH; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Emel L; Fred Hutchinson Cancer Research Center, Seattle, WA, USA., Sun R; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Zhang TH; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Chiu SH; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Stranix-Chibanda L; University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe., Chipato T; University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe., Ship H; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Mohtashemi NZ; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Kintu K; Makerere University- Johns Hopkins University Research Collaboration, Kampala, Uganda., Manji KP; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Moodley D; Centre for the AIDS Programme of Research in South Africa and Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa., Maldonado Y; Stanford University, Stanford, CA., Currier JS; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Thio CL; Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: AIDS (London, England) [AIDS] 2024 Mar 01; Vol. 38 (3), pp. 329-337. Date of Electronic Publication: 2023 Oct 17.
DOI: 10.1097/QAD.0000000000003752
Abstrakt: Objectives: To describe the clinical and virologic characteristics of HIV-HBV coinfection, including the predictors of high maternal HBV viral load in pregnant women with HIV in sub-Saharan Africa (SSA).
Methods: HPTN 046 was a HIV perinatal transmission clinical trial evaluating infant nevirapine vs. placebo. Women-infant pairs ( n  = 2016) were enrolled in SSA from 2007 to 2010; 1579 (78%) received antiretrovirals (ARV). Maternal delivery samples were retrospectively tested for hepatitis B surface antigen (HBsAg), and if positive, were tested for hepatitis B e antigen (HBeAg) and HBV viral load (VL). High HBV VL was defined as ≥10 6  IU/ml.
Results: Overall, 4.4% (88/2016) had HBV co-infection, with geographic variability ranging from 2.4% to 8.7% ( P  < 0.0001); 25% (22/88) were HBeAg positive with prevalence in countries ranging from 10.5% to 39%. Fifty-two percentage (40/77) of those with HBV received ARV, the majority (97%) received 3TC as the only HBV active agent. HBeAg positivity was associated with high maternal HBV VL, odds ratio (OR) 37.0, 95% confidence interval (CI) 5.4-252.4. Of those with high HBV VL, 40% (4/10) were receiving HBV active drugs (HBV-ARV). HBV drug resistance occurred in 7.5% (3/40) receiving HBV-ARV.
Conclusions: In SSA, HBV co-infection is common in pregnant women with HIV. HBsAg and HBeAg prevalence vary widely by country in this clinical trial cohort. HBeAg is a surrogate for high HBV viral load. HBV drug resistance occurred in 7.5% receiving HBV-ARV with lamivudine as the only HBV active agent. These findings reinforce the importance of HBsAg screening and early treatment with two active agents for HBV.
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Databáze: MEDLINE
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