Impact of hepatitis b virus infection on human immunodeficiency virus response to antiretroviral therapy in Nigeria

John Idoko, Seema Meloni, Mohammed Muazu, Ladep Nimzing, Bitrus Badung, Claudia A Hawkins, Jean Louis Sankalé, Ernest Ekong, Robert Leo Murphy, Phyllis Kanki, Chloe L. Thio

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

ackground. As highly active antiretroviral therapy (ART) is introduced into areas of the world in which hepatitis B virus (HBV) infection is highly endemic, it is important to determine the influence of HBV on persons with human immunodeficiency virus (HIV) and HBV coinfection who are receiving ART. Methods. We studied 1564 HIV-infected patients in Jos, Nigeria, who initiated ART. Participants with HIVHBV coinfection had hepatitis B e antigen (HBeAg) and HBV DNA status determined. CD4+ T cell count and HIV load at ART initiation were compared between individuals with HIV monoinfection and those with HIVHBV coinfection with use of univariate methods. Regression analyses were used to determine if HBeAg status or HBV DNA at ART initiation were associated with baseline HIV parameters or ART response. Results. The median CD4 + T cell count of the 262 participants with HIV-HBV coinfection (16.7%) was 107 cells/mL, compared with 130 cells/mL for participants with HIV monoinfection at ART initiation (P<.001). Participants with HIV-HBV coinfection also had higher HIV loads than did patients with HIV monoinfection (4.96 vs 4.75 log10, copies/mL; p = .02). Higher HBV DNA and detectable HBeAg levels were independently associated with lower CD4+ T cell counts at ART initiation but not with higher HIV loads. In a multivariable model, HBeAg-positive patients were less likely than HBeAg-negative patients to suppress HIV replication to ≤400 copies/mL (odds ratio, 0.54; P= .03) at 24 weeks, but they had similar CD4+ T cell increases. At 48 weeks, there was no significant effect of HBeAg status on ART response. Conclusions. Among HIV-infected Nigerian individuals, HBV coinfection, especially among those with high levels of HBV replication, was associated with lower CD4+ T cell counts at ART initiation, independent of HIV RNA level. Patients with HBeAg-positive status had a slower virological response to ART, compared with HBeAgnegative patients. Further work is needed to understand the effects of HBV on CD4+ T cells.

Original languageEnglish (US)
Pages (from-to)1268-1273
Number of pages6
JournalClinical Infectious Diseases
Volume49
Issue number8
DOIs
StatePublished - Oct 15 2009

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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