Clinical Outcomes during Treatment Interruptions in Human Immunodeficiency Virus-Hepatitis B Virus Co-infected Patients from Sub-Saharan Africa
| Autor: | Boyd, Anders, Houghtaling, Laura, Moh, Raoul, Chekaraou, Mariama Abdou, Gabillard, Delphine, Eholié, Serge Paul, Anglaret, Xavier, Zoulim, Fabien, Danel, Christine, Lacombe, Karine, Matthieu, Abanou, Isabelle, Adou, Adou, Aman, Ibouraîma, Bakayoko, Léontine, Bombo, Edwidge, Cissé, Ali, Coulibaly, Lucien, Djédjé, Edouard, Djobi Djo, Jocelyn, Goly, Marie-Cécile, Kassi, Justine, Koffi, Aholi, Koffi N.Dri, Sylvie, Konan, Mamadou, Konaté, Bertin, Kouadio, Martin, Kouamé, Martin, Kouadio, Victoire, Kouadio, Adrienne, Kouakou, Yao, Kouakou, Antoine, Kouamé, Ferdinand, Kouamé, Gérald, Kouamé, Justine, Kouamé, Georgette, Labibi, Jean, Lehou, Jules, Moh, Mariam, Moussa Doumbia, Marie-Pierre, Martin, Julie, N'Dri Marie, Tuo, Nalourgou, Célestin, N'Chot, Brou, N'Goran, Marie-Pascale, Nogbout, Joanna, Orne Gliemann, Bakary, Ouattara, Minata, Ouattara, Joséphine, Oupoh, Abdelh, Sidibé, Bertine, Siloué, Adidiata, Soro, Amah-Cécile, Tchehy, Juliette, Yao, Guei, Yoro, Marcel, Zaho |
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| Přispěvatelé: | Gestionnaire, Hal Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Minnesota [Twin Cities] (UMN), University of Minnesota System, Programme PAC-CI, ANRS France Recherche Nord & sud Sida-hiv hépatites, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), Université Félix Houphouët-Boigny (UFHB), Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Infectious diseases |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
HBsAg Hepatitis B virus Sub saharan [SDV]Life Sciences [q-bio] Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Virus Replication Virus law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Virology Internal medicine Antiretroviral Therapy Highly Active medicine Humans 030212 general & internal medicine Africa South of the Sahara Hepatitis B Surface Antigens business.industry Coinfection Incidence (epidemiology) Incidence virus diseases Articles Hepatitis B [SDV] Life Sciences [q-bio] Infectious Diseases Cote d'Ivoire Treatment Outcome DNA Viral HIV-1 Severe morbidity 030211 gastroenterology & hepatology Parasitology Morbidity business Follow-Up Studies |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene The American Journal of Tropical Medicine and Hygiene, 2017, 97 (6), pp.1936--1942. ⟨10.4269/ajtmh.16-1016⟩ American journal of tropical medicine and hygiene, 97(6), 1936-1942. American Society of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | Antiretroviral treatment (ART) interruptions increase the risk of severe morbidity/mortality in human immunodeficiency virus (HIV)-infected individuals from subSaharan Africa. We aimed to determine whether the risk is further increased among HIV-hepatitis B virus (HBV) co-infected patients in this setting. In this sub-analysis of a randomized-control trial, 632 participants from Cote d'Ivoire randomized to receive continuous-ART (C-ART), structured ART interruptions of 2-months off, 4-months on (2/4-ART), and CD4-guided ART interruptions (CD4GT, interruption at 350/mm3 and reintroduction at 250/mm3) were analyzed. Incidence rates (IR) of serious HIV- and non-HIV-related morbidity were compared between patients stratified on hepatitis B surface antigen (HBsAg) status. Overall, 65 (10.3%) were HBsAg-positive, 29 (44.6%) of whom had HBV-DNA levels > 10,000 copies/mL. After a median 2.0 year (range = 0.2-3.1) follow-up, ≥ 1 serious HIV-related events occurred in 101 HIV mono-infected and 15 HIV-HBV co-infected patients (IR = 10.0 versus 13.2/100 person/years, respectively, P = 0.3), whereas the highest incidence was observed in co-infected patients with baseline HBV-replication > 10,000 copies/mL (IR = 24.0/100 person/years, P versus HIV mono-infected = 0.002). Incidence of bacterial infections was also highest in the co-infected group with HBV-replication > 10,000 copies/mL (IR = 12.9 versus 3.3/100 person/years in HIV mono-infected patients, P = 0.001). The relative effect of CD4GT or 2/4-ART versus C-ART was not different between infection groups (P for interaction = 0.4). No increase in the incidence of non-HIV-related morbidity was observed for co-infected patients (P = 0.5), even at HBV-replication levels > 10,000 copies/mL (P = 0.7). In conclusion, co-infected patients with elevated HBV-replication at ART-initiation are more susceptible to HIV-related morbidity, especially invasive bacterial diseases, during treatment interruption. |
| Databáze: | OpenAIRE |
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