Please use this identifier to cite or link to this item: http://cmuir.cmu.ac.th/jspui/handle/6653943832/51266
Title: Long-term hepatitis B virus (HBV) response to Lamivudine-containing highly active antiretroviral therapy in HIV-HBV co-infected patients in Thailand
Authors: Woottichai Khamduang
Catherine Gaudy-Graffin
Nicole Ngo-Giang-Huong
Gonzague Jourdain
Alain Moreau
Nuananong Luekamlung
Guttiga Halue
Yuwadee Buranawanitchakorn
Sura Kunkongkapan
Sudanee Buranabanjasatean
Marc Lallemant
Wasna Sirirungsi
Alain Goudeau
Keywords: Agricultural and Biological Sciences
Biochemistry, Genetics and Molecular Biology
Medicine
Issue Date: 31-Jul-2012
Abstract: Background: Approximately 4 million of people are co-infected with HIV and Hepatitis B virus (HBV). In resource-limited settings, the majority of HIV-infected patients initiate first-line highly active antiretroviral therapy containing lamivudine (3TC-containing-HAART) and long-term virological response of HBV to lamivudine-containing HAART in co-infected patients is not well known. Methodology/Principal Finding: HIV-HBV co-infected patients enrolled in the PHPT cohort (ClinicalTrials.gov NCT00433030) and initiating a 3TC-containing-HAART regimen were included. HBV-DNA, HIV-RNA, CD4+ T-cell counts and alanine transaminase were measured at baseline, 3 months, 12 months and then every 6 months up to 5 years. Kaplan-Meier analysis was used to estimate the cumulative rates of patients who achieved and maintained HBV-DNA suppression. Of 30 co-infected patients, 19 were positive for HBe antigen (HBeAg). At initiation of 3TC-containing-HAART, median HBV DNA and HIV RNA levels were 7.35 log10 IU/mL and 4.47 log10 copies/mL, respectively. At 12 months, 67% of patients achieved HBV DNA suppression: 100% of HBeAg-negative patients and 47% of HBeAg-positive. Seventy-three percent of patients had HIV RNA below 50 copies/mL. The cumulative rates of maintained HBV-DNA suppression among the 23 patients who achieved HBV-DNA suppression were 91%, 87%, and 80% at 1, 2, and 4 years respectively. Of 17 patients who maintained HBV-DNA suppression while still on 3TC, 4 (24%) lost HBsAg and 7 of 8 (88%) HBeAg-positive patients lost HBeAg at their last visit (median duration, 59 months). HBV breakthrough was observed only in HBeAg-positive patients and 6 of 7 patients presenting HBV breakthrough had the rtM204I/V mutations associated with 3TC resistance along with rtL180M and/or rtV173L. Conclusions: All HBeAg-negative patients and 63% of HBeAg-positive HIV-HBV co-infected patients achieved long-term HBV DNA suppression while on 3TC-containing-HAART. This study provides information useful for the management of co-infected patients in resource-limited countries where the vast majority of co-infected patients are currently receiving 3TC. © 2012 Khamduang et al.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84864447642&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/51266
ISSN: 19326203
Appears in Collections:CMUL: Journal Articles

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