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Original article

Six-year follow-up of hepatitis B surface antigen concentrations in tenofovir disoproxil fumarate treated HIV–HBV-coinfected patients

Vincent Thibault, Hind Stitou, Nathalie Desire, Marc-Antoine Valantin, Roland Tubiana, Christine Katlama

Corresponding author name: Vincent Thibault
Corresponding author e-mail: vincent.thibault@psl.aphp.fr

Citation: Antiviral Therapy 2011; 16:199-205
doi: 10.3851/IMP1723

Date accepted: 25 July 2010
Date published online: 27 January 2011

Abstract

Background: Quantitative measurement of hepatitis B surface antigen (HBsAg) has been proposed as a surrogate marker of treatment efficacy when HBV DNA load becomes undetectable. Our main objective was to study the kinetics of HBsAg level in HIV–HBV-coinfected patients with undetectable HBV DNA load under treatment containing tenofovir disoproxil fumarate (TDF).

Methods: A retrospective analysis was performed on frozen serum samples of 33 HIV–HBV-coinfected patients who were treated with TDF and had undetectable HBV DNA for ≥1 year. Baseline and serial follow-up samples were assayed for HBsAg levels.

Results: The characteristics of the patients at TDF initiation were median age 43.6 years, median HBV DNA load 2 log10 IU/ml and median HBsAg concentration 3.4 log10 IU/ml. Ten patients were positive for hepatitis B e antigen. Baseline median HBsAg concentration, defined 1 year after HBV DNA became undetectable, was 3.1 log10 IU/ml. Overall, from years 1 to 6 and a median duration of TDF treatment of 2.6 years, the median HBsAg concentration decreased slowly. Notably, only 13 (39%) patients presented a constant decrease of HBsAg concentration, whereas the remaining had fluctuating or increasing HBsAg concentrations. The slope was not influenced by HBeAg status, HIV infection duration and CD4+ T-cell count at baseline or at nadir.

Conclusions: Despite control of HBV DNA replication under efficient TDF treatment, HBsAg levels persistently decreased in only 39% of HIV–HBV-coinfected patients. Larger follow-up studies are needed to determine whether HBsAg concentration monitoring under analogue treatment can be used as a reliable marker for HBV clearance.

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