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HBV infection may be linked to low CD4 count at ART initiation
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Patients with HIV who were coinfected with hepatitis B virus had an average of almost 25 fewer CD4 cells/mL than patients with HIV only at antiretroviral therapy initiation, according to results of a recent study from Nigeria.
The study involved 1,564 patients with HIV who initiated antiretroviral therapy (ART). The researchers determined the hepatitis B e antigen and HBV DNA status of patients coinfected with HIV-HBV. Comparisons were made between coinfected patients and monoinfected patients in two areas at ART initiation: CD4 cell counts and HIV viral load.
There were 262 (16.7%) coinfected patients. At ART initiation, the average CD4 cell count among this population was 107 cells/mL, compared with 130 cells/mL among HIV monoinfected patients.
Coinfected patients had higher viral loads than monoinfected patients, 4.96 vs. 4.75 log10 copies/mL.
Higher HBV DNA and detectable hepatitis B e antigen levels were independently associated with lower CD4 cell counts at ART initiation. Those were not associated with higher HIV viral loads.
Multivariate analysis indicated that patients who were positive for hepatitis B e antigen at ART initiation were less likely to suppress HIV replication to <400 copies/mL than patients who were negative for the antigen at the 24-week mark. Similar CD4 count increases were observed among patients who tested positive and those who tested negative for the antigen.
Forty-eight-week data demonstrated that antigen status did not significantly affect ART response.
Idoko J et al. Clin Infect Dis. 2009;49:1268-1273.