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在3TC+DTG开关后,HBcAb阳性作为缺失HIVRNA不可检测性的风险因素

Vincenzo Malagnino^1,2, Tiziana Mulas¹, Elisabetta Teti¹

¹Infectious Disease Unit, Policlinico Tor Vergata of Rome, 00133 Rome, Italy.

|March 28, 2024

概括

乙型肝炎核心抗体 (HBcAb) 阳性,这是隐性乙型肝炎感染的标志物,在切换到两种药物 (3TC-DTG) 方案后,与较差的HIV控制有关. 对这些患者来说,仔细监测至关重要.

科学领域:

传染性疾病传染性疾病
病毒学病毒学
免疫学免疫学免疫学

背景情况:

乙型肝炎核心抗体 (HBcAb) 的阳性表明隐藏的乙型肝炎感染 (OBI).
OBI不是两种药物抗逆转录病毒疗法 (2DR) 的禁忌,但消除tenofovir可能会影响HBV控制.
这项研究考察了HBcAb阳性对2DR简化过程中的HIV控制的影响.

研究的目的:

研究HBcAb阳性对转换为2DR (Lamivudine/Dolutegravir) 患者的HIV控制的影响.
为了比较2DR治疗的HBcAb阳性和HBcAb阴性个体之间的HIV-RNA抑制率.

主要方法:

一项多中心回顾性队列研究包括267名2DR (3TC-DTG) 患者.
患者被分为HBcAb-阳性或-阴性.
艾滋病毒RNA抑制被评估为<20 cp/mL (未检测到目标),<20 cp/mL (检测到目标) 和>20 cp/mL.

主要成果:

与HBcAb阴性患者相比,HBcAb阳性患者年龄较大,CD4+最低点较低.
在切换之前,没有观察到病毒抑制的差异.
切换后12个月,24个月和36个月,HBcAb阳性患者实现目标未检测 (<20 cp/mL) 的患者显著减少 (69.3%,72.5%,66.7%) 与HBcAb阴性患者 (85.4%,89.9%,92.8%) 相比.

结论:

在简化到3TC/DTG后,HBcAb阳性与低最佳HIV抑制的风险增加有关.
这突显了OBI在艾滋病毒感染者 (PLWH) 中的临床相关性.
建议在2DR治疗中对PLWH与OBI进行仔细的病毒学监测.

关键词:

HBcAb++是什么意思艾滋病毒/HBV感染者这就是OBI,OBI.

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