Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort

Tongai G Maponga, Anna L McNaughton, Marije van Schalkwyk, Susan Hugo, Chikezie Nwankwo, Jantjie Taljaard, Jolynne Mokaya, David A Smith, Cloete van Vuuren, Dominique Goedhals, Shiraaz Gabriel, Monique I Andersson, Wolfgang Preiser, Christo van Rensburg, Philippa C Matthews*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

OBJECTIVES: Prompted by international targets for elimination of hepatitis B virus (HBV), we set out to characterise individuals with HBV monoinfection vs. those coinfected with HBV/HIV, to evaluate the impact of therapy and to guide improvements in clinical care.

METHODS: We report observational data from a real world cross-sectional cohort of 115 adults with chronic hepatitis B infection (CHB), at a university hospital in Cape Town, South Africa. HIV coinfection was present in 39 (34%) subjects. We recorded cross-sectional demographic, clinical and laboratory data.

RESULTS: Compared to those with HIV coinfection, HBV monoinfected adults were less likely to be HBeAg-positive (p=0.01), less likely to have had assessment with elastography (p<0.0001), and less likely to be on antiviral treatment (p<0.0001); they were more likely to have detectable HBV viraemia (p=0.04), and more likely to have features of liver disease including moderate/severe thrombocytopaenia (p=0.007), elevated bilirubin (p=0.004), and elevated APRI score (p=0.02). Three cases of hepatocellular carcinoma all arose in HBV monoinfection.

CONCLUSIONS: Our data demonstrate that individuals with HBV monoinfection may be disadvantaged compared to those with HIV coinfection, highlighting potential systematic inequities in referral, monitoring and treatment.

Original languageEnglish
Pages (from-to)121-130
Number of pages10
JournalJournal of Infection
Volume81
Issue number1
DOIs
Publication statusPublished - 3 May 2020

Keywords

  • Hepatitis B virus
  • HBV
  • HIV
  • treatment
  • elimination
  • viral load
  • Tenofovir
  • Dolutegravir
  • Hepatocellular carcinoma
  • South Africa
  • coinfection
  • sustainable development goals

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