Higher Mortality Despite Early Antiretroviral Therapy in Human Immunodeficiency Virus and Hepatitis B Virus (HBV)-Coinfected Patients With High HBV Replication

Autor: KOUAME, Menan Gerard, Boyd, A., Moh, Raoul, Badje, Anani dodzi, Gabillard, Delphine, OUATTARA, Eric, N'Takpe, Jean-Baptiste, EMIEME, A., Maylin, S., CHEKARAOU, M. A., Eholie, Serge Paul, Zoulim, F., Lacombe, K., Anglaret, Xavier, Danel, Christine
Přispěvatelé: Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Clinical Infectious Diseases
Clinical Infectious Diseases, Oxford University Press (OUP), 2018, 66 (1), pp.112-120. ⟨10.1093/cid/cix747⟩
ISSN: 1058-4838
1537-6591
DOI: 10.1093/cid/cix747⟩
Popis: Background: In HIV-infected patients, hepatitis B virus (HBV)-coinfection increases the risk of disease progression. Tenofovir+emtricitabine/lamivudine (TDF/XTC)-based antiretroviral therapy (ART), which suppresses HIV and HBV replication, has the potential for decreasing this risk. Here, we analyze the association between HBV replication, early-ART, and mortality in West-African adults. Methods: The Temprano randomized-control trial assessed the benefits of immediately initiating versus deferring ART in HIV-infected adults with high CD4 counts. After trial completion, participants continued follow-up in a post-trial phase. We analyzed the association between HBV-status, immediate-ART, and mortality over the entire trial and post-trial follow-up using multivariable Cox proportional hazards regression. Results: 2052 HIV-infected adults (median baseline CD4=464/mm3) were followed for 9394 person-years. At baseline, 1862 (91%) were HIV-monoinfected and 190 (9%) HIV-HBV-coinfected. Of the latter, 135 (71%) had plasma HBV-DNA /=2000 IU/ml. The 60-month probability of death was 11.8% (95%CI=5.4-24.5) in coinfected patients with HBV-DNA >/=2000 IU/ml, 4.4% (95%CI=1.9-10.4) in coinfected patients with HBV-DNA /=2000 IU/ml and 0.90 (95%CI=0.36-2.24) in coinfected patients with HBV-DNA
Databáze: OpenAIRE
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