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Poorer antiretroviral response among HIV patients with HBV, HCV coinfection
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Patients with HIV coinfected with hepatitis B or hepatitis C virus experienced poorer outcomes from antiretroviral therapy compared with monoinfected patients in a study presented at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.
Researchers evaluated data collected from the TREAT Asia HIV Observational Database on 7,455 patients with HIV treated at 22 Asian hospitals. All participants received antiretroviral therapy (ART), with a target HIV viral load (VL) of fewer than 1,000 copies/mL. Among patients with evaluable test results, 10.45% were coinfected with HBV and 15.2% with HCV.
After 180 days of therapy, CD4 counts were significantly lower among patients coinfected with either HBV (adjusted difference=–15.5 cells/mcL; P=.011) or HCV (aDiff=–37.8 cells/mcL; P<.001) compared with monoinfected patients after initiating ART. CD4 increases were smaller among those with HIV subtype CRF01AE compared with subtype B (–35.5 cells/mcL; P=.026).
The target VL was achieved in a median of 1.28 years within the cohort. Patients coinfected with HBV or HCV experienced a longer time to VL than monoinfected participants, but this difference was not statistically significant.
Coinfected patients had poorer survival than monoinfected patients. Multivariate analysis indicated a significant association between mortality and HCV coinfection (adjusted HR=1.81; 95% CI, 1.2-2.71). No association was observed between HIV VL and coinfection with either HBV or HCV.
“In this Asia regional HIV cohort, patients with HBV or HCV coinfection had significantly lower CD4 counts [and] smaller CD4 increases after 180 days of ART,” the researchers concluded. “We need to test, identify and initiate [highly active] ART early in HBV and HCV coinfected [patients] to have a better treatment effect.”
For more information:
Chen YMA. TULBPE13: HBV and HCV Coinfection: Long-term Immunological, Virological and Survival Outcomes Following cART. Presented at: IAS Conference on HIV Pathogenesis, Treatment and Prevention; June 30-July 03, 2013; Kuala Lumpur, Malaysia.