Circulating HBV RNA and hepatitis B core-related antigen trajectories in persons with HIV/HBV coinfection and HBsAg loss on tenofovir therapy.

HBV RNA HIV Hepatitis B Core-related Antigen Hepatitis B cure Hepatitis B virus Kinetics Tenofovir

Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
16 Apr 2024
Historique:
received: 02 11 2023
revised: 28 02 2024
accepted: 09 04 2024
medline: 16 4 2024
pubmed: 16 4 2024
entrez: 16 4 2024
Statut: aheadofprint

Résumé

We evaluated long-term trajectories of circulating hepatitis B virus (HBV)-RNA and hepatitis B core-related antigen (HBcrAg) in persons with and without hepatitis B surface antigen (HBsAg) loss during tenofovir therapy in the Swiss HIV Cohort Study. We included 29 persons with HIV (PWH) with HBsAg loss and 29 matched PWH without loss. We compared HBV-RNA and HBcrAg decline and assessed the cumulative proportions with undetectable HBV-RNA and HBcrAg levels during tenofovir therapy using Kaplan-Meier estimates. HBsAg loss occurred after a median of 4 years (IQR 1 - 8). All participants with HBsAg loss achieved suppressed HBV-DNA and undetectable HBV-RNA preceding undetectable qHBsAg levels, whereas 79% achieved negative HBcrAg. In comparison, 79% of the participants without HBsAg loss achieved undetectable HBV-RNA and 48% negative HBcrAg. After two years on tenofovir, an HBV RNA decline ≥1 log10 copies/ml had 100% sensitivity and 36.4% specificity for HBsAg loss, whereas an HBcrAg decline ≥1 log10 U/ml had 91.0% sensitivity and 64.5% specificity. HBV-RNA suppression preceded undetectable qHBsAg levels, and had high sensitivity but low specificity for HBsAg loss during tenofovir therapy in PWH. HBcrAg remained detectable in approximately 20% of persons with, and 50% of persons without HBsAg loss.

Sections du résumé

BACKGROUND BACKGROUND
We evaluated long-term trajectories of circulating hepatitis B virus (HBV)-RNA and hepatitis B core-related antigen (HBcrAg) in persons with and without hepatitis B surface antigen (HBsAg) loss during tenofovir therapy in the Swiss HIV Cohort Study.
METHODS METHODS
We included 29 persons with HIV (PWH) with HBsAg loss and 29 matched PWH without loss. We compared HBV-RNA and HBcrAg decline and assessed the cumulative proportions with undetectable HBV-RNA and HBcrAg levels during tenofovir therapy using Kaplan-Meier estimates.
RESULTS RESULTS
HBsAg loss occurred after a median of 4 years (IQR 1 - 8). All participants with HBsAg loss achieved suppressed HBV-DNA and undetectable HBV-RNA preceding undetectable qHBsAg levels, whereas 79% achieved negative HBcrAg. In comparison, 79% of the participants without HBsAg loss achieved undetectable HBV-RNA and 48% negative HBcrAg. After two years on tenofovir, an HBV RNA decline ≥1 log10 copies/ml had 100% sensitivity and 36.4% specificity for HBsAg loss, whereas an HBcrAg decline ≥1 log10 U/ml had 91.0% sensitivity and 64.5% specificity.
CONCLUSIONS CONCLUSIONS
HBV-RNA suppression preceded undetectable qHBsAg levels, and had high sensitivity but low specificity for HBsAg loss during tenofovir therapy in PWH. HBcrAg remained detectable in approximately 20% of persons with, and 50% of persons without HBsAg loss.

Identifiants

DOI: 10.1093/infdis/jiae189 PMID: 38626170
pubmed: 38626170
pii: 7646749
doi: 10.1093/infdis/jiae189
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

I Abela (I)
K Aebi-Popp (K)
A Anagnostopoulos (A)
M Battegay (M)
E Bernasconi (E)
D L Braun (DL)
H C Bucher (HC)
A Calmy (A)
M Cavassini (M)
A Ciuffi (A)
G Dollenmaier (G)
M Egger (M)
L Elzi (L)
J Fehr (J)
J Fellay (J)
H Furrer (H)
C A Fux (CA)
H F Günthard (HF)
A Hachfeld (A)
D Haerry (D)
B Hasse (B)
H H Hirsch (HH)
M Hoffmann (M)
I Hösli (I)
M Huber (M)
D Jackson-Perry (D)
C R Kahlert (CR)
O Keiser (O)
T Klimkait (T)
R D Kouyos (RD)
H Kovari (H)
K Kusejko (K)
N Labhardt (N)
K Leuzinger (K)
B Martinez de Tejada (BM)
C Marzolini (C)
K J Metzner (KJ)
N Müller (N)
J Nemeth (J)
D Nicca (D)
J Notter (J)
P Paioni (P)
G Pantaleo (G)
M Perreau (M)
A Rauch (A)
L Salazar-Vizcaya (L)
P Schmid (P)
R Speck (R)
M Stöckle (M)
P Tarr (P)
A Trkola (A)
G Wandeler (G)
M Weisser (M)
S Yerly (S)

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Auteurs

Lorin Begré (L)

Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
ORCID: 0000-0003-1015-8947

Anders Boyd (A)

Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
stichting hiv monitoring Amsterdam, Amsterdam, The Netherlands.
Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, The Netherlands.
Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands.
ORCID: 0000-0001-9512-8928

Marie-Laure Plissonnier (ML)

Inserm Unit 1052, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon Hepatology Institute, Lyon, France.
ORCID: 0000-0003-4879-4586

Barbara Testoni (B)

Inserm Unit 1052, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon Hepatology Institute, Lyon, France.
ORCID: 0000-0001-5588-5465

Luisa Salazar-Vizcaya (L)

Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
ORCID: 0000-0003-0527-0141

Franziska Suter-Riniker (F)

Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
ORCID: 0000-0001-8568-578X

Caroline Scholtès (C)

Inserm Unit 1052, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon Hepatology Institute, Lyon, France.
Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France.

Charles Béguelin (C)

Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
ORCID: 0000-0001-9346-5146

Jürgen K Rockstroh (JK)

HIV-Clinic, Department of Medicine I, University Hospital Bonn, Bonn, Germany.
ORCID: 0000-0003-2858-3888

Huldrych F Günthard (HF)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
ORCID: 0000-0002-1142-6723

Alexandra Calmy (A)

Division of Infectious Diseases, University Hospital Geneva, University of Geneva, Geneva, Switzerland.
ORCID: 0000-0002-1137-6826

Matthias Cavassini (M)

Division of Infectious Diseases, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
ORCID: 0000-0003-0933-7833

Hans H Hirsch (HH)

Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
ORCID: 0000-0003-0883-0423

Patrick Schmid (P)

Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
ORCID: 0000-0003-1978-5082

Enos Bernasconi (E)

Division of Infectious Diseases, Ente Ospedaliero Cantonale Lugano, University of Geneva and University of Southern Switzerland, Lugano, Switzerland.
ORCID: 0000-0002-9724-8373

Massimo Levrero (M)

Inserm Unit 1052, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon Hepatology Institute, Lyon, France.
ORCID: 0000-0002-4978-0875

Gilles Wandeler (G)

Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
ORCID: 0000-0002-5278-8763

Fabien Zoulim (F)

Inserm Unit 1052, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon Hepatology Institute, Lyon, France.
ORCID: 0000-0002-2245-0083

Andri Rauch (A)

Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
ORCID: 0000-0001-5297-6062

Classifications MeSH