Prevalence, clinical and virologic outcomes of hepatitis B virus co-infection in HIV-1 positive Kenyan women on antiretroviral therapy
Sub-Saharan Africa carries a high burden of co-infection with HIV-1 and hepatitis B virus (HBV). In this region, individuals with HIV-1/HBV co-infection on antiretroviral therapy (ART) frequently receive lamivudine as the only agent active against HBV, raising concerns for development of HBV resista...
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| Veröffentlicht in: | PloS one 2013-03, Vol.8 (3), p.e59346-e59346 |
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| creator | Day, Summer L Odem-Davis, Katherine Mandaliya, Kishorchandra N Jerome, Keith R Cook, Linda Masese, Linnet N Scott, John Kim, H Nina Graham, Susan M McClelland, R Scott |
| description | Sub-Saharan Africa carries a high burden of co-infection with HIV-1 and hepatitis B virus (HBV). In this region, individuals with HIV-1/HBV co-infection on antiretroviral therapy (ART) frequently receive lamivudine as the only agent active against HBV, raising concerns for development of HBV resistance to lamivudine. We aimed to determine the prevalence, clinical, and virologic outcomes of chronic HBV infection, including HBV resistance to lamivudine, in a cohort of HIV-1 seropositive Kenyan women on long-term ART.
In this prospective cohort study, HIV-1 seropositive women initiated three-drug ART regimens that included lamivudine as the single drug active against HBV. Archived samples were tested for HBsAg, with further testing to determine HBeAg seroprevalence, HBV DNA suppression, and lamivudine resistance. We estimated the prevalence of chronic HBV and examined associations between HBV co-infection and clinical and virologic outcomes with chi-square tests, logistic regression, Kaplan-Meier and Cox regression.
In a cohort of 159 women followed for a median of 3.4 years (interquartile range 1.4-4.5), 11 (6.9%; 95% CI 3.1-10.7) had chronic HBV infection. Of these, 9 (82%) achieved undetectable plasma HBV DNA levels. One woman developed lamivudine resistance, for an incidence of 3 per 100 person-years. The HBV co-infected women were at greater risk for abnormal ALT elevations compared to HIV-1 mono-infected women (HR 2.37; 95% CI 1.1-5.3). There were no differences between HBV-infected and uninfected women in mortality, CD4 count, or HIV-1 RNA suppression.
The prevalence of chronic HBV in this cohort was similar to recent studies from other African populations. Given our long-term follow-up, lamivudine resistance was lower than expected for HIV-1/HBV co-infected patients. Improved screening for HBV and extended follow-up of HIV-1/HBV co-infected individuals are needed to better understand the impact of different ART regimens on clinical outcomes in this population. |
| doi_str_mv | 10.1371/journal.pone.0059346 |
| format | Article |
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In this prospective cohort study, HIV-1 seropositive women initiated three-drug ART regimens that included lamivudine as the single drug active against HBV. Archived samples were tested for HBsAg, with further testing to determine HBeAg seroprevalence, HBV DNA suppression, and lamivudine resistance. We estimated the prevalence of chronic HBV and examined associations between HBV co-infection and clinical and virologic outcomes with chi-square tests, logistic regression, Kaplan-Meier and Cox regression.
In a cohort of 159 women followed for a median of 3.4 years (interquartile range 1.4-4.5), 11 (6.9%; 95% CI 3.1-10.7) had chronic HBV infection. Of these, 9 (82%) achieved undetectable plasma HBV DNA levels. One woman developed lamivudine resistance, for an incidence of 3 per 100 person-years. The HBV co-infected women were at greater risk for abnormal ALT elevations compared to HIV-1 mono-infected women (HR 2.37; 95% CI 1.1-5.3). There were no differences between HBV-infected and uninfected women in mortality, CD4 count, or HIV-1 RNA suppression.
The prevalence of chronic HBV in this cohort was similar to recent studies from other African populations. Given our long-term follow-up, lamivudine resistance was lower than expected for HIV-1/HBV co-infected patients. Improved screening for HBV and extended follow-up of HIV-1/HBV co-infected individuals are needed to better understand the impact of different ART regimens on clinical outcomes in this population.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0059346</identifier><identifier>PMID: 23527168</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Alanine Transaminase - blood ; Anti-Retroviral Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Biological products industry ; Biology ; CD4 antigen ; CD4-Positive T-Lymphocytes - immunology ; Chronic infection ; Cohort analysis ; Cohort Studies ; Coinfection - epidemiology ; Deoxyribonucleic acid ; DNA ; DNA, Viral - blood ; Drug resistance ; Drug Resistance, Viral - genetics ; Female ; Health aspects ; Health risk assessment ; Hepatitis ; Hepatitis B ; Hepatitis B - drug therapy ; Hepatitis B - epidemiology ; Hepatitis B e antigen ; Hepatitis B surface antigen ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV-1 - genetics ; Human immunodeficiency virus ; Humans ; Infection ; Kaplan-Meier Estimate ; Kenya - epidemiology ; Laboratories ; Lamivudine ; Lamivudine - therapeutic use ; Logistic Models ; Medicine ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Ribonucleic acid ; RNA ; Serology ; Sex Workers ; Therapy ; Treatment Outcome ; Viruses ; Womens health</subject><ispartof>PloS one, 2013-03, Vol.8 (3), p.e59346-e59346</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Day et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Day et al 2013 Day et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-974260aa7a105ff9b4fda383a9051aa9cfce4ad76674f4df2c8e0323439cf84c3</citedby><cites>FETCH-LOGICAL-c692t-974260aa7a105ff9b4fda383a9051aa9cfce4ad76674f4df2c8e0323439cf84c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601052/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601052/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23527168$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Day, Summer L</creatorcontrib><creatorcontrib>Odem-Davis, Katherine</creatorcontrib><creatorcontrib>Mandaliya, Kishorchandra N</creatorcontrib><creatorcontrib>Jerome, Keith R</creatorcontrib><creatorcontrib>Cook, Linda</creatorcontrib><creatorcontrib>Masese, Linnet N</creatorcontrib><creatorcontrib>Scott, John</creatorcontrib><creatorcontrib>Kim, H Nina</creatorcontrib><creatorcontrib>Graham, Susan M</creatorcontrib><creatorcontrib>McClelland, R Scott</creatorcontrib><title>Prevalence, clinical and virologic outcomes of hepatitis B virus co-infection in HIV-1 positive Kenyan women on antiretroviral therapy</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Sub-Saharan Africa carries a high burden of co-infection with HIV-1 and hepatitis B virus (HBV). In this region, individuals with HIV-1/HBV co-infection on antiretroviral therapy (ART) frequently receive lamivudine as the only agent active against HBV, raising concerns for development of HBV resistance to lamivudine. We aimed to determine the prevalence, clinical, and virologic outcomes of chronic HBV infection, including HBV resistance to lamivudine, in a cohort of HIV-1 seropositive Kenyan women on long-term ART.
In this prospective cohort study, HIV-1 seropositive women initiated three-drug ART regimens that included lamivudine as the single drug active against HBV. Archived samples were tested for HBsAg, with further testing to determine HBeAg seroprevalence, HBV DNA suppression, and lamivudine resistance. We estimated the prevalence of chronic HBV and examined associations between HBV co-infection and clinical and virologic outcomes with chi-square tests, logistic regression, Kaplan-Meier and Cox regression.
In a cohort of 159 women followed for a median of 3.4 years (interquartile range 1.4-4.5), 11 (6.9%; 95% CI 3.1-10.7) had chronic HBV infection. Of these, 9 (82%) achieved undetectable plasma HBV DNA levels. One woman developed lamivudine resistance, for an incidence of 3 per 100 person-years. The HBV co-infected women were at greater risk for abnormal ALT elevations compared to HIV-1 mono-infected women (HR 2.37; 95% CI 1.1-5.3). There were no differences between HBV-infected and uninfected women in mortality, CD4 count, or HIV-1 RNA suppression.
The prevalence of chronic HBV in this cohort was similar to recent studies from other African populations. Given our long-term follow-up, lamivudine resistance was lower than expected for HIV-1/HBV co-infected patients. Improved screening for HBV and extended follow-up of HIV-1/HBV co-infected individuals are needed to better understand the impact of different ART regimens on clinical outcomes in this population.</description><subject>Adult</subject><subject>Alanine Transaminase - blood</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Biological products industry</subject><subject>Biology</subject><subject>CD4 antigen</subject><subject>CD4-Positive T-Lymphocytes - immunology</subject><subject>Chronic infection</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Coinfection - epidemiology</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>DNA, Viral - blood</subject><subject>Drug resistance</subject><subject>Drug Resistance, Viral - genetics</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>Hepatitis B - drug therapy</subject><subject>Hepatitis B - epidemiology</subject><subject>Hepatitis B e antigen</subject><subject>Hepatitis B surface antigen</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV-1 - genetics</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infection</subject><subject>Kaplan-Meier Estimate</subject><subject>Kenya - epidemiology</subject><subject>Laboratories</subject><subject>Lamivudine</subject><subject>Lamivudine - therapeutic use</subject><subject>Logistic Models</subject><subject>Medicine</subject><subject>Prevalence</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Ribonucleic acid</subject><subject>RNA</subject><subject>Serology</subject><subject>Sex Workers</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Viruses</subject><subject>Womens health</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99u0zAUxiMEYmPwBggsTUIg0WLHjpPcII0JWMWkIf7s1jp1TlpXqV1sp9AX4LlxaDe1aBfIF7Hs3_ednHN8suwpo2PGS_Zm4XpvoRuvnMUxpUXNhbyXHbOa5yOZU35_b3-UPQphkSBeSfkwO8p5kZdMVsfZ788e19Ch1fia6M5Yo6EjYBuyNt51bmY0cX3UbomBuJbMcQXRRBPIu4HoA9FuZGyLOhpnibHkYnI9YmTlQqLWSD6h3YAlP5OBJYkAG43H6F1Sp0hxjh5Wm8fZgxa6gE9235Ps-4f3384vRpdXHyfnZ5cjLes8jupS5JIClMBo0bb1VLQN8IpDTQsGUOtWo4CmlLIUrWjaXFdIec4FT1eV0Pwke771XXUuqF0Jg2Kc06rmvGCJmGyJxsFCrbxZgt8oB0b9PXB-psBHoztUHBifsoZyVleiERJKWgmK0xRUFtOmTV5vd9H66RIbjTamnA9MD2-smauZWysuaUowTwYvdwbe_egxRLU0QWPXgUXXD__NaslEwQf09B_07ux21Cz1XKW-uRRXD6bqTJRVnhe0HLzGd1BpNbg0Or231qTzA8GrA0FiIv6KM-hDUJOvX_6fvbo-ZF_ssXOELs6D6_rhrYVDUGxB7V0IHtvbIjOqhnG5qYYaxkXtxiXJnu036FZ0Mx_8D79UES0</recordid><startdate>20130318</startdate><enddate>20130318</enddate><creator>Day, Summer L</creator><creator>Odem-Davis, Katherine</creator><creator>Mandaliya, Kishorchandra N</creator><creator>Jerome, Keith R</creator><creator>Cook, Linda</creator><creator>Masese, Linnet N</creator><creator>Scott, John</creator><creator>Kim, H Nina</creator><creator>Graham, Susan M</creator><creator>McClelland, R Scott</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130318</creationdate><title>Prevalence, clinical and virologic outcomes of hepatitis B virus co-infection in HIV-1 positive Kenyan women on antiretroviral therapy</title><author>Day, Summer L ; Odem-Davis, Katherine ; Mandaliya, Kishorchandra N ; Jerome, Keith R ; Cook, Linda ; Masese, Linnet N ; Scott, John ; Kim, H Nina ; Graham, Susan M ; McClelland, R Scott</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-974260aa7a105ff9b4fda383a9051aa9cfce4ad76674f4df2c8e0323439cf84c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Alanine Transaminase - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Day, Summer L</au><au>Odem-Davis, Katherine</au><au>Mandaliya, Kishorchandra N</au><au>Jerome, Keith R</au><au>Cook, Linda</au><au>Masese, Linnet N</au><au>Scott, John</au><au>Kim, H Nina</au><au>Graham, Susan M</au><au>McClelland, R Scott</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence, clinical and virologic outcomes of hepatitis B virus co-infection in HIV-1 positive Kenyan women on antiretroviral therapy</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-03-18</date><risdate>2013</risdate><volume>8</volume><issue>3</issue><spage>e59346</spage><epage>e59346</epage><pages>e59346-e59346</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Sub-Saharan Africa carries a high burden of co-infection with HIV-1 and hepatitis B virus (HBV). In this region, individuals with HIV-1/HBV co-infection on antiretroviral therapy (ART) frequently receive lamivudine as the only agent active against HBV, raising concerns for development of HBV resistance to lamivudine. We aimed to determine the prevalence, clinical, and virologic outcomes of chronic HBV infection, including HBV resistance to lamivudine, in a cohort of HIV-1 seropositive Kenyan women on long-term ART.
In this prospective cohort study, HIV-1 seropositive women initiated three-drug ART regimens that included lamivudine as the single drug active against HBV. Archived samples were tested for HBsAg, with further testing to determine HBeAg seroprevalence, HBV DNA suppression, and lamivudine resistance. We estimated the prevalence of chronic HBV and examined associations between HBV co-infection and clinical and virologic outcomes with chi-square tests, logistic regression, Kaplan-Meier and Cox regression.
In a cohort of 159 women followed for a median of 3.4 years (interquartile range 1.4-4.5), 11 (6.9%; 95% CI 3.1-10.7) had chronic HBV infection. Of these, 9 (82%) achieved undetectable plasma HBV DNA levels. One woman developed lamivudine resistance, for an incidence of 3 per 100 person-years. The HBV co-infected women were at greater risk for abnormal ALT elevations compared to HIV-1 mono-infected women (HR 2.37; 95% CI 1.1-5.3). There were no differences between HBV-infected and uninfected women in mortality, CD4 count, or HIV-1 RNA suppression.
The prevalence of chronic HBV in this cohort was similar to recent studies from other African populations. Given our long-term follow-up, lamivudine resistance was lower than expected for HIV-1/HBV co-infected patients. Improved screening for HBV and extended follow-up of HIV-1/HBV co-infected individuals are needed to better understand the impact of different ART regimens on clinical outcomes in this population.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23527168</pmid><doi>10.1371/journal.pone.0059346</doi><tpages>e59346</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2013-03, Vol.8 (3), p.e59346-e59346 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1330893351 |
| source | PubMed (Medline); MEDLINE; Public Library of Science; Directory of Open Access Journals; Free Full-Text Journals in Chemistry; EZB Electronic Journals Library |
| subjects | Adult Alanine Transaminase - blood Anti-Retroviral Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Biological products industry Biology CD4 antigen CD4-Positive T-Lymphocytes - immunology Chronic infection Cohort analysis Cohort Studies Coinfection - epidemiology Deoxyribonucleic acid DNA DNA, Viral - blood Drug resistance Drug Resistance, Viral - genetics Female Health aspects Health risk assessment Hepatitis Hepatitis B Hepatitis B - drug therapy Hepatitis B - epidemiology Hepatitis B e antigen Hepatitis B surface antigen HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV-1 - genetics Human immunodeficiency virus Humans Infection Kaplan-Meier Estimate Kenya - epidemiology Laboratories Lamivudine Lamivudine - therapeutic use Logistic Models Medicine Prevalence Proportional Hazards Models Prospective Studies Ribonucleic acid RNA Serology Sex Workers Therapy Treatment Outcome Viruses Womens health |
| title | Prevalence, clinical and virologic outcomes of hepatitis B virus co-infection in HIV-1 positive Kenyan women on antiretroviral therapy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T18%3A15%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence,%20clinical%20and%20virologic%20outcomes%20of%20hepatitis%20B%20virus%20co-infection%20in%20HIV-1%20positive%20Kenyan%20women%20on%20antiretroviral%20therapy&rft.jtitle=PloS%20one&rft.au=Day,%20Summer%20L&rft.date=2013-03-18&rft.volume=8&rft.issue=3&rft.spage=e59346&rft.epage=e59346&rft.pages=e59346-e59346&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0059346&rft_dat=%3Cgale_plos_%3EA478225072%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1330893351&rft_id=info:pmid/23527168&rft_galeid=A478225072&rft_doaj_id=oai_doaj_org_article_3a13b1d031984d46a70840ebc8e65bdf&rfr_iscdi=true |