Hepatitis B Surface Antigen Concentrations in Patients with HIV/HBV Co-Infection

被引:38
作者
Jaroszewicz, Jerzy [1 ,7 ]
Reiberger, Thomas [2 ]
Meyer-Olson, Dirk [3 ]
Mauss, Stefan [4 ]
Vogel, Martin [5 ]
Ingiliz, Patrick [6 ]
Payer, Berit Anna [2 ]
Stoll, Matthias [3 ]
Manns, Michael P. [1 ]
Schmidt, Reinhold E. [3 ]
Flisiak, Robert [7 ]
Wedemeyer, Heiner [1 ]
Peck-Radosavljevic, Markus [2 ]
Rockstroh, Juergen [5 ]
Cornberg, Markus [1 ]
机构
[1] Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, D-3000 Hannover, Germany
[2] Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Vienna, Austria
[3] Hannover Med Sch, Dept Clin Immunol & Rheumatol, D-3000 Hannover, Germany
[4] Ctr HIV & Hepatogastroenterol, Dusseldorf, Germany
[5] Univ Bonn, Dept Internal Med 1, Bonn, Germany
[6] Med Ctr Infect Dis MIB, Berlin, Germany
[7] Med Univ Bialystok, Dept Infect Dis & Hepatol, Bialystok, Poland
关键词
HIV-INFECTED PATIENTS; NATURAL-HISTORY; SERUM-LEVELS; VIRUS; EPIDEMIOLOGY; PREDICTION; TENOFOVIR; KINETICS; DECLINE;
D O I
10.1371/journal.pone.0043143
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
HBsAg clearance is associated with clinical cure of chronic hepatitis B virus (HBV) infection. Quantification of HBsAg may help to predict HBsAg clearance during the natural course of HBV infection and during antiviral therapy. Most studies investigating quantitative HBsAg were performed in HBV mono-infected patients. However, the immune status is considered to be important for HBsAg decline and subsequent HBsAg loss. HIV co-infection unfavorably influences the course of chronic hepatitis B. In this cross-sectional study we investigated quantitative HBsAg in 173 HBV/HIV co-infected patients from 6 centers and evaluated the importance of immunodeficiency and antiretroviral therapy. We also compared 46 untreated HIV/HBV infected patients with 46 well-matched HBV mono-infected patients. HBsAg levels correlated with CD4 T-cell count and were higher in patients with more advanced HIV CDC stage. Patients on combination antiretroviral therapy (cART) including nucleos(t)ide analogues active against HBV demonstrated significant lower HBsAg levels compared to untreated patients. Importantly, HBsAg levels were significantly lower in patients who had a stronger increase between nadir CD4 and current CD4 T-cell count during cART. Untreated HIV/HBV patients demonstrated higher HBsAg levels than HBV mono-infected patients despite similar HBV DNA levels. In conclusion, HBsAg decline is dependent on an effective immune status. Restoration of CD4 T-cells during treatment with cART including nucleos(t) ide analogues seems to be important for HBsAg decrease and subsequent HBsAg loss.
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页数:8
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