Editor’s Note:
The 8th Asia-Pacific AIDS and Co-infection Conference (APACC 2023) was held in Singapore from June 8 to 10, 2023. During this conference, an oral presentation (Abstract #9) conducted by Dr. Linghua Li’s team from the Eighth Affiliated Hospital, Guangzhou Medical University, China, attracted significant attention. Dr. Li ‘s team, based on the latest findings from a large cohort study, revealed that the hepatitis B surface antigen (HBsAg) clearance rate in HIV/HBV co-infected individuals who received long-term combination antiretroviral therapy (cART) could reach 8.1%. Furthermore, the research results unveiled that the main influencing factors for HBsAg clearance in HIV/HBV co-infected individuals included low baseline HBsAg levels, HBV genotype B, and a more than two-fold increase in ALT within six months of treatment.
Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share similar transmission routes, making co-infection common. Currently, there are approximately 2.7 million HIV/HBV co-infected patients worldwide. Compared to HBV mono-infected patients, those with HIV/HBV co-infection face significantly higher risks of developing liver cirrhosis, liver cancer, liver decompensation, liver-related mortality, and all-cause mortality. Curing hepatitis B is the ultimate goal of HBV treatment, and HBsAg clearance is a crucial indicator of hepatitis B cure. Little is known about the HBsAg clearance rate in Chinese HIV/HBV co-infected patients after long-term cART use and the influencing factors.
The Infectious Disease Center of the Eighth Affiliated Hospital of Guangzhou Medical University conducted a retrospective study involving over 1,500 cases of HIV/HBV co-infection. The study aimed to explore the HBsAg clearance rate and influencing factors in patients receiving cART, with an observation endpoint as of December 2020.
Between 2009 and December 2020, a total of 1,550 HIV/HBV co-infected patients were enrolled in the study, with 86% being male. Ninety-six point two percent (96.2%) of patients received cART regimens that included tenofovir for hepatitis B. A total of 7,777 person-years of follow-up were conducted, with a median follow-up time of 4.7 years (IQR: 3.1-6.8). Throughout the follow-up period, 126 patients (8.1%) achieved HBsAg clearance, with a clearance rate of 1.7/100 person-years. Multivariate Cox regression analysis revealed a significant association between baseline low HBsAg levels (<1500 COI, aHR=2.74, 95% CI: 1.48-5.09), HBV genotype B (aHR=3.73, 95% CI: 1.46-9.59), a more than two-fold increase in ALT within six months of treatment (aHR=2.96, 95% CI: 1.53-5.77), and HBsAg clearance.
While the overall HBsAg clearance rate in the HIV/HBV co-infected population following cART can approach 10%, the person-year clearance rate remains low. It is necessary to develop hepatitis B cure strategies based on interferon or other immune modulation therapies tailored to the factors influencing HBsAg clearance.
Original Article Link:
He Y, Lin W, LI H, Cai W, Tang X, Li L, et al. Incidence and Factors Associated with Hepatitis B Surface Antigen Seroclearance in HIV/HBV Coinfected Patients During Combination Antiretroviral Therapy. APACC 2023 Abstract #9
