Increased Risk of Virologic Failure in HBV/HIV Coinfected Patients on HAART

Strategic Insights -

Human immunodeficiency virus (HIV)-infected patients with chronic hepatitis B virus (HBV) coinfection face a higher risk of virologic failure after initiation of highly active antiretroviral therapy (HAART). A study conducted in Taiwan found that between June 1994 and February 2003, 111 HIV-infected patients with HBV coinfection had a median duration of observation of 25 months. Results showed that coinfected patients were more likely to develop hepatitis and hepatic decompensation compared to HIV-infected patients without HBV coinfection. Notably, HBV-infected patients had an increased risk of virologic failure and death after HAART was initiated.

Key Takeaways:

  • The study observed 111 HIV-infected patients with HBV coinfection and 387 HIV-infected patients without HBV coinfection over a median duration of 25 months.
  • Coinfected patients had a higher risk of developing hepatitis (adjusted hazard ratio, 2.54; 95% confidence interval, 1.69-3.82) and hepatic decompensation (adjusted odds ratio, 9.94; 95% confidence interval, 1.89-52.35).
  • Although both groups showed similar increases in CD4 count and development of new opportunistic illnesses, HBV-infected patients had a greater risk of virologic failure (adjusted odds ratio, 1.76; 95% confidence interval, 1.03-2.99) and death (adjusted hazard ratio, 1.71; 95% confidence interval, 1.19-2.47).
  • The study highlights the importance of considering HBV coinfection when treating HIV-infected patients with HAART.
  • Dr. W.H. Sheng and researchers from National Taiwan University Hospital conducted the study, published in Clinical Infectious Diseases.

Statistics:

  • 111 HIV-infected patients with HBV coinfection were observed in the study.
  • 387 HIV-infected patients without HBV or hepatitis C virus coinfection were observed for comparison.
  • The median duration of observation was 25 months.
  • 2.54 was the adjusted hazard ratio for hepatitis development in coinfected patients.
  • 9.94 was the adjusted odds ratio for hepatic decompensation in coinfected patients.
  • 1.76 was the adjusted odds ratio for virologic failure in HBV-infected patients.
  • 1.71 was the adjusted hazard ratio for death in HBV-infected patients.

Sources:

  • W.H. Sheng et al., "Impact of chronic hepatitis B virus (HBV) infection on outcomes of patients infected with HIV in an area where HBV infection is hyperendemic," Clinical Infectious Diseases, 2004;38(10):1476-1482.
  • National Taiwan University Hospital, Department of Internal Medicine, 7 Chung Shan S Rd., Taipei 100, Taiwan.
  • University Chicago Press, 1427 E 60TH St., Chicago, IL 60637-2954 USA.