Response of hepatitis B virus to antiretroviral treatment containing lamivudine in HBsAg-positive and HBsAg-negative HIV-positive South African adults

J Med Virol. 2019 May;91(5):758-764. doi: 10.1002/jmv.25375. Epub 2018 Dec 18.

Abstract

Both hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection are highly endemic in sub-Saharan Africa. This study examined serological and clinical follow-up data from 39 HBV DNA-positive, HIV-positive black South African adults, who returned for follow-up at 3, 6, 12, and 18 months post-initiation of antiretroviral therapy (ART). Of the 39 participants, 10 experienced full suppression of HBV and 29 experienced no suppression, with 10 of these showing a virological breakthrough. All 10 patients who fully suppressed were HBsAg-negative, with 16 of the 29 who did not suppress being HBsAg-positive and 13 HBsAg-negative (P < 0.05). Participants fully suppressing the virus had significantly lower aminotransferase levels and were all HBsAg-negative compared to those who did not suppress (P < 0.05). HBV viral loads between HBsAg-positive and HBsAg-negative samples were similar at baseline and at the final time-point. In these South African patients with HBV/HIV coinfection, HBsAg-negative status at baseline was a predictor of the outcome of HBV suppression in response to ART containing lamivudine.

Keywords: occult; overt; suppression; virological breakthrough.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Child
  • Cohort Studies
  • Coinfection / drug therapy*
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy*
  • Hepatitis B / complications*
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B virus / isolation & purification*
  • Humans
  • Lamivudine / therapeutic use*
  • Male
  • Middle Aged
  • South Africa
  • Treatment Outcome
  • Viral Load
  • Young Adult

Substances

  • Anti-Retroviral Agents
  • Hepatitis B Surface Antigens
  • Lamivudine