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

doi:10.1016/j.jinf.2020.04.037

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 journal › Article (Academic Journal) › peer-review

12 Citations (Scopus)

70 Downloads (Pure)

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 language	English
Pages (from-to)	121-130
Number of pages	10
Journal	Journal of Infection
Volume	81
Issue number	1
DOIs	https://doi.org/10.1016/j.jinf.2020.04.037
Publication status	Published - 3 May 2020

Keywords

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jinf.2020.04.037

Full-text PDF (final published version)
This is the final published version of the article (version of record). It first appeared online via Elsevier at https://doi.org/10.1016/j.jinf.2020.04.037 . Please refer to any applicable terms of use of the publisher.
Final published version, 1.79 MBLicence: CC BY

Handle.net

Persistent link

Cite this

Maponga, T. G., McNaughton, A. L., van Schalkwyk, M., Hugo, S., Nwankwo, C., Taljaard, J., Mokaya, J., Smith, D. A., van Vuuren, C., Goedhals, D., Gabriel, S., Andersson, M. I., Preiser, W., van Rensburg, C., & Matthews, P. C. (2020). Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort. Journal of Infection, 81(1), 121-130. https://doi.org/10.1016/j.jinf.2020.04.037

@article{17231ed79101495ea1277774b41ea485,

title = "Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort",

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.",

keywords = "Hepatitis B virus, HBV, HIV, treatment, elimination, viral load, Tenofovir, Dolutegravir, Hepatocellular carcinoma, South Africa, coinfection, sustainable development goals",

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

year = "2020",

month = may,

day = "3",

doi = "10.1016/j.jinf.2020.04.037",

language = "English",

volume = "81",

pages = "121--130",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "W.B. Saunders",

number = "1",

}

Maponga, TG, McNaughton, AL, van Schalkwyk, M, Hugo, S, Nwankwo, C, Taljaard, J, Mokaya, J, Smith, DA, van Vuuren, C, Goedhals, D, Gabriel, S, Andersson, MI, Preiser, W, van Rensburg, C & Matthews, PC 2020, 'Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort', Journal of Infection, vol. 81, no. 1, pp. 121-130. https://doi.org/10.1016/j.jinf.2020.04.037

TY - JOUR

T1 - Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort

AU - Maponga, Tongai G

AU - McNaughton, Anna L

AU - van Schalkwyk, Marije

AU - Hugo, Susan

AU - Nwankwo, Chikezie

AU - Taljaard, Jantjie

AU - Mokaya, Jolynne

AU - Smith, David A

AU - van Vuuren, Cloete

AU - Goedhals, Dominique

AU - Gabriel, Shiraaz

AU - Andersson, Monique I

AU - Preiser, Wolfgang

AU - van Rensburg, Christo

AU - Matthews, Philippa C

PY - 2020/5/3

Y1 - 2020/5/3

N2 - 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.

AB - 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.

KW - Hepatitis B virus

KW - HBV

KW - HIV

KW - treatment

KW - elimination

KW - viral load

KW - Tenofovir

KW - Dolutegravir

KW - Hepatocellular carcinoma

KW - South Africa

KW - coinfection

KW - sustainable development goals

U2 - 10.1016/j.jinf.2020.04.037

DO - 10.1016/j.jinf.2020.04.037

M3 - Article (Academic Journal)

C2 - 32360882

SN - 0163-4453

VL - 81

SP - 121

EP - 130

JO - Journal of Infection

JF - Journal of Infection

IS - 1

ER -

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

Abstract

Keywords

UN SDGs

Access to Document

Handle.net

Fingerprint

Cite this