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A comparison of hepatitis B virus infection in HIV-infected and HIV-uninfected participants enrolled in a multinational clinical trial: HPTN 052
Registro en:
10.1097/QAI.0000000000001511
GREER, Amy E. et al. A comparison of hepatitis B virus infection in HIV-infected and HIV-uninfected participants enrolled in a multi-national clinical trial: HPTN 052. Journal of Acquired Immune Deficiency Syndromes, v. 76, n. 4, p. 1-16, Dec. 2017.
Autor
Greer, Amy E.
Ou, San-San
Wilson, Ethan
Piwowar-Manning, Estelle
Forman, Michael S.
McCauley, Marybeth
Gamble, Theresa
Ruangyuttikarn, Cholticha
Hosseinipour, Mina C.
Kumarasamy, Nagalingeswaran
Nyirenda, Mulinda
Grinsztejn, Beatriz
Pilotto, Jose Henrique
Kosashunhanan, Natthapol
Gonçalves de Melo, Marineide
Makhema, Joseph
Akelo, Victor
Panchia, Ravindre
Badal-Faesen, Sharlaa
Chen, Ying Q.
Cohen, Myron S.
Eshleman, Susan H.
Thio, Chloe L.
Valsamakis, Alexandra
Resumen
Objective — Data comparing hepatitis B virus (HBV) infection in HIV-infected [HIV(+)], and HIV-uninfected [HIV(−)] individuals recruited into the same study are limited. HBV infection status and chronic hepatitis B (cHB) were characterized in a multi-national clinical trial: HIV Prevention Trials Network (HPTN 052). Method — HBV infection status at enrollment was compared between HIV(+) (N=1241) and HIV(−) (N=1232) from seven HBV-endemic countries. Hepatitis B e antigen (HBeAg) and plasma HBV DNA were determined in cHB. Median CD4, median plasma HIV RNA, and prevalence of transaminase elevation were compared in HIV(+) with and without cHB. Significance was assessed with Chi-square, Fisher’s exact, and median tests. Results — Among all participants, 33.6% had HBV exposure without cHB (8.9% isolated HBV core antibody, “HBcAb”; 24.7% HBcAb and anti-HB surface antibody positive, “recovered”), 4.3% had cHB, 8.9% were vaccinated, and 53.5% were uninfected. Data were similar among HIV(+) and HIV(−) except for isolated HBV core antibody (HBcAb), which was more prevalent in HIV(+) than HIV(−) [10.1% vs. 7.7%, P=0.046]. Median HBV DNA trended higher in HIV(+) than in HIV(−). In HIV(+) with cHB versus those without cHB, transaminase elevations were more prevalent (ALT ≤ Grade 2, 12% vs. 5.2%, P=0.037; AST ≤ Grade 2, 26% vs. 6.0%, P<0.001), CD4 trended lower, and HIV RNA was similar. Conclusions — HBV infection status did not differ by HIV infection status. HIV co-infection was associated with isolated HBcAb and a trend of increased HBV DNA. In HIV, cHB was associated with mild transaminase elevations and a trend toward lower CD4.
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