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Long-Term TDF-Inclusive ART and Progressive Rates of HBsAg Loss in HIV-HBV Coinfection-Lessons for Functional HBV
Jennifer Audsley1,2, Anchalee Avihingsanon3, Margaret Littlejohn4
1The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia.
Journal of Acquired Immune Deficiency Syndromes (1999)
|July 22, 2020
Summary
Tenofovir disoproxil fumarate (TDF) ART leads to high rates of hepatitis B surface antigen (HBsAg) loss in HIV-HBV coinfection over five years. This demonstrates durable viral control and offers insights into functional hepatitis B virus (HBV) cure strategies.
Area of Science:
- Infectious Diseases
- Hepatology
- Virology
Background:
- Tenofovir disoproxil fumarate (TDF) effectively suppresses HIV and HBV replication.
- Persistent HBV DNA can occur in some individuals with HIV-HBV coinfection on TDF-based antiretroviral therapy (ART).
Purpose of the Study:
- To assess the durability of HBV virological control.
- To evaluate clinical outcomes after prolonged TDF-based ART in HIV-HBV coinfection.
Main Methods:
- Prospective longitudinal study of 92 HIV-HBV coinfected participants.
- Follow-up for up to 5 years with 6-monthly and annual assessments.
- Monitoring of laboratory (HBV DNA, HIV RNA, HBsAg) and clinical parameters.
Main Results:
- Hepatitis B surface antigen (HBsAg) loss occurred in 12.0% of the cohort over 5 years.
- Lower baseline quantitative HBsAg was associated with HBsAg loss.
- By year 5, 98.5% had undetectable HBV DNA and 91.4% had undetectable HIV RNA.
Conclusions:
- High and ongoing HBsAg loss observed over 5 years of TDF-based ART in HIV-HBV coinfection.
- Undetectable HBV DNA was nearly universal.
- Findings may inform strategies for a functional HBV cure.
