Coinfection with hepatitis B virus (HBV) was linked with a diminished rise in immune function and an increased risk of death among Kenyans starting treatment for HIV, aidsmap reports. However, taking Viread (tenofovir disoproxil fumarate, or TDF), which treats both hep B and HIV, was linked with a diminished difference in the mortality risk.
Researchers conducted a retrospective analysis of data from the African Infectious Disease Village Clinics in the Rift Valley province of Kenya, looking at the hep B prevalence among people with HIV enrolling in care programs for the virus between 2003 and 2012. They presented their findings at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.
The cohort included 7,155 people who were followed for a cumulative 12,408 years, or an average of 1.75 years apiece. They were monitored every three months and prescribed ARVs according to World Health Organization guidelines.
A total of 451 people, or 6.3 percent, tested positive for hepatitis B surface antigen (HBsAg), meaning they were coinfected with hep B. During their first year on HIV treatment, these individuals had poorer CD4 cell recovery compared with the HBsAg-negative individuals—a respective 110-cell increase versus a 135-cell increase—despite the fact that the two groups had similar rates of HIV viral suppression.
During the first year on HIV treatment, 9.3 percent of the HBsAg-positive individuals died compared with 5.3 percent of the HBsAg-negative individuals. After adjusting the data for various factors, the researchers found that being HBsAg positive was liked with an 84 percent increased risk of death.
Those HBsAg-positive individuals treated with Viread (which is a component of numerous combination tablet HIV treatments), on the other hand, did not have a statistically significant increased risk of death compared with the HBsAg-negative individuals, meaning that any apparent increased risk may have been the result of chance. The HBsAg-positive people who did not take Viread, however, had a 3.32-fold increased risk of death compared with HBsAg-negative people, a difference that was statistically significant.
The researchers concluded that prescribing non-Viread-containing HIV regimens among sub-Saharan Africans should be accompanied by testing for HBsAg.
To read the aidsmap article, click here.
To read the conference abstract, click here.