Article

EuroSIDA Group. Hepatitis B and HIV: Prevalence, AIDS progression, response to highly active antiretroviral therapy and increased mortality in the EuroSIDA cohort

Hospital de Santa Maria, Lisboa, Lisbon, Portugal
AIDS (Impact Factor: 5.55). 03/2005; 19(6):593-601. DOI: 10.1097/01.aids.0000163936.99401.fe
Source: PubMed

ABSTRACT

Whether hepatitis B (HBV) coinfection affects outcome in HIV-1-infected patients remains unclear.
To assess the prevalence of HBV (assessed as HBsAg) coinfection and its possible impact on progression to AIDS, all-cause deaths, liver-related deaths and response to highly active antiretroviral therapy (HAART) in the EuroSIDA cohort.
Data on 9802 patients in 72 European HIV centres were analysed. Incidence rates of AIDS, global mortality and liver-related mortality, time to 25% CD4 cell count increase and time to viral load < 400 copies/ml after starting HAART were calculated and compared between HBsAg-positive and HBsAg-negative patients.
HBsAg was found in 498 (8.7%) patients. The incidence of new AIDS diagnosis was similar in HBsAg-positive and HBsAg-negative patients (3.3 and 3.4/100 person-years, respectively) even after adjustment for potential confounders: the incidence rate ratio (IRR) was 0.94 [95% confidence interval (CI), 0.74-1.19; P = 0.61]. The incidences of all-cause and liver-related mortalities were significantly higher in HBsAg-positive subjects (3.7 and 0.7/100 person-years, respectively) compared with HBsAg-negative subjects (2.6 and 0.2/100 person-years, respectively). The adjusted IRR values were 1.53 for global (95% CI, 1.23-1.90; P = 0.0001) and 3.58 for liver-related (95% CI, 2.09-6.16; P < 0.0001) mortality. HBsAg status did not influence viral or immunological responses among the 1679 patients starting HAART.
The prevalence of HBV coinfection was 9% in the EuroSIDA cohort. Chronic HBV infection significantly increased liver-related mortality in HIV-1-infected patients but did not impact on progression to AIDS or on viral and immunological responses to HAART.

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    • "The prevalence of total anti-HBc in younger age groups was lower than among older women in 2012. In addition, unlike studies in the United States, Europe, and Ghana, which reported higher prevalence of chronic HBV infection among HIV-infected patients2829303132, we did not find a significant association between HIV and HBV infection in this study which is similar to findings reported among pregnant women in Uganda, Cameroon, and India333435. Given that HIV and HBV have similar modes of transmission, preventive interventions targeting HIV infection, such as HIV counseling, testing, and treatment services available at those ANC site, and screening of blood for HIV and hepatitis B in Haiti, might have led to the decrease in HBV infection rates among pregnant women in Haiti [36, 37]. "
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    ABSTRACT: Background: Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule. Objectives: Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT. Study design: We selected 1364 residual serum specimens collected during a 2012 human immunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection. Results: Of 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, p<0.001), and 33 specimens (2.5%) were HBsAg positive (2.1% in West vs. 3% in non-West, p=0.4). Of HBsAg positive specimens, 79% had detectable HBV DNA. Women aged 30 and older had more than double the odds of positive total anti-HBc than women aged 15-19 years (p<0.001). Women with secondary (adjusted odds ratio (aOR)=0.54; 95% CI: 0.36-0.81) and post-secondary education (aOR=0.40, 95% CI: 0.19-0.79) had lower odds of total anti-HBc positivity compared with women with no education. HIV-status was not associated with HBV infection. Conclusions: Haiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission.
    No preview · Article · Jan 2016 · Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology
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    • "On the 83 coinfection cases, we noted the presence of 53 (20.3%) cases of HIV/HBV coinfection and 30 (11.5%) cases of HIV/HCV coinfection. The estimated prevalence of chronic hepatitis B in our survey population was raised, very superior to the one observed in the cohort European EuroSida which was of 8.7%[15]and also comparable to the one made on the population been born in sub-Saharan Africa which was of 10.8%, as well as of the one observed in these countries (9%)[16]. The estimated prevalence of the HCV infection was on the other hand veryweak compared to those estimated in the ANRS-Vespa investigation (22%)[17]and National investigation (28%) in 2001[18]. "
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    Full-text · Dataset · Jan 2016
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    • "On the 83 coinfection cases, we noted the presence of 53 (20.3%) cases of HIV/HBV coinfection and 30 (11.5%) cases of HIV/HCV coinfection. The estimated prevalence of chronic hepatitis B in our survey population was raised, very superior to the one observed in the cohort European EuroSida which was of 8.7%[15]and also comparable to the one made on the population been born in sub-Saharan Africa which was of 10.8%, as well as of the one observed in these countries (9%)[16]. The estimated prevalence of the HCV infection was on the other hand veryweak compared to those estimated in the ANRS-Vespa investigation (22%)[17]and National investigation (28%) in 2001[18]. "
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    ABSTRACT: The present study was aimed at optimizing the biomedical handling of the hepatotoxicity caused by the HAART accentuated in case of coinfection with the hepatitis viruses among the patients infected with the human immunodeficiency virus (HIV). We performed a prospective transversal survey from 18th March 2014 to 30th October 2014, on patients infected with HIV followed at the Bertoua day hospital with the general objective to evaluate the impact of the viral coinfection (HIV-Hepatitis Virus) on the incidence of hepatotoxicity cases caused by the HAART. We included in our survey, all HIV positive patients, eligible to the antiretroviral treatment, registered in our survey place for the follow-up of this treatment and having accepted to participate in the survey. We excluded in our survey, all patients who were not registered at the Bertoua day hospital for the follow-up of the antiretroviral treatment, all patients presenting a hepatic affection other that the infection with hepatitis virus, all patients having a bad observance of the antiretroviral treatment. We made the screening of the hepatitis B and C infections with the help of two tests: a fast screening test with the small strips to hepatitis B and C (DIASPOT type) and a confirmation test with the fast diagnosis cassettes (BIOLINE type). We analyzed the socio-demographic parameters (Age and Sex), Biological parameters (HIV, HCV, HBV, Transaminases) and the therapeutic parameters (therapeutic protocol). Two hundred and sixty one (261) HIV positive patients have been included in our survey, among which we counted 197 women and 64 men with a sex ratio of 0.32 in favor of women. We noted the presence of 53 coinfection cases with HIV-HBV (20.3%) and 30 coinfection cases with HIV-HCV (11.5%), that is a total of 83 coinfection cases (31.8%). The prevalence’s of hepatotoxicity cases among the coinfected and monoinfected patients were 85.54% and 5.05% respectively and their incidence rates were also of 22.6% and 6.1% respectively. The time limit of the hepatotoxicity appearance among our patients, varied from 4 to 6 months. Keywords: Hepatotoxicity; HIV; Hepatitis C; Hepatitis B; HAART.
    Full-text · Article · Jan 2016
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