Higher risk of mortality in HIV-HBV co-infected patients from sub-Saharan Africa is observed at lower CD4+ cell counts

被引：4

作者：

Kouame, Gerard M. ^{[1
,2
,3
]}

Gabillard, Delphine ^{[2
,3
]}

Moh, Raoul ^{[1
,4
]}

Badje, Anani ^{[1
,3
]}

Ntakpe, Jean B. ^{[1
,3
]}

Emieme, Arlette ^{[5
]}

Maylin, Sarah ^{[6
]}

Toni, Thomas dAquin ^{[5
]}

Menan, Herve ^{[5
]}

Zoulim, Fabien ^{[7
,8
]}

Danel, Christine ^{[1
,2
,3
]}

Anglaret, Xavier ^{[1
,2
,3
]}

Eholie, Serge ^{[1
,9
]}

Lacombe, Karine ^{[11
]}

Boyd, Anders ^{[10
,11
]}

机构：

[1] MEREVA, Programme PAC CI Site ANRS Cote dIvoire, Abidjan, Cote Ivoire

[2] Univ Bordeaux, Bordeaux, France

[3] INSERM UMR1219 IDLIC, Bordeaux, France

[4] UFR Sci Med, Unite Pedag Dermatol & Infectiol, Abidjan, Cote Ivoire

[5] CHU Treichville, Lab CeDreS, Abidjan, Cote Ivoire

[6] Hop St Louis, AP HP, Lab Virol, Paris, France

[7] Univ Claude Bernard Lyon 1, Univ Lyon, Ctr Leon Berard, Ctr Rech Cancerol Lyon CRCL, Lyon, France

[8] Hosp Civils Lyon HCL, Lyon, France

[9] CHU Treichville, Serv Malad Infect & Trop, Abidjan, Cote Ivoire

[10] Hop St Antoine, Serv Malad Infect & Trop, 184 Rue Faubourg St Antoine, F-75012 Paris, France

[11] Inst Pierre Louis Epidemiol & Sante Publ, UMR S1136, INSERM, Paris, France

来源：

ANTIVIRAL THERAPY | 2021年 / 26卷 / 1-2期

关键词：

B-VIRUS COINFECTION; EARLY ANTIRETROVIRAL THERAPY; HUMAN-IMMUNODEFICIENCY-VIRUS; HEPATITIS-B; IMMUNOLOGICAL RECOVERY; INDIVIDUALS; LIVER; PROGRESSION; OUTCOMES; IMPACT;

D O I：

10.1177/13596535211039589

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Hepatitis B virus (HBV) co-infection in human immunodeficiency virus (HIV)-positive individuals increases the risk of overall mortality, especially when HBV DNA levels are high. The role of CD4(+) cell counts in this association is poorly defined. We aimed to determine whether HIV-HBV co-infection influences changes in CD4(+) cell count before and during antiretroviral therapy and whether it affects mortality risk at levels of CD4(+). Methods: 2052 HIV-positive participants from Cote d'Ivoire in a randomized-control trial assessing early or deferred ART were included. HBV-status was determined by hepatitis B surface antigen (HBsAg). Changes in CD4(+) cell levels were estimated using a mixed-effect linear model. The incidence rates of all-cause mortality were estimated at CD4(+) counts <= 350, 351-500, >500/mm(3) and were compared between HBV-status groups as incidence rate ratios (IRR). Results: At baseline, 190 (9%) were HBsAg-positive [135 (71%) with HBV DNA <2000 IU/nnL, 55 (29%) >= 2000 IU/nnL]. Follow-up was a median 58 months (IQR = 40-69). Between co-infection groups, there were no differences in CD4(+) decline before ART initiation and no differences in CD4(+) increase after ART initiation. After adjusting for sex, age, baseline HIV RNA level, and early/ deferred ART arm, mortality rates were not significantly different between HBsAg-positive versus HBsAg-negative participants across strata of CD4(+) levels. However, HBsAg-positive individuals with HBV-DNA >= 2000 IU/mL versus HBsAg-negative individuals had increased mortality rates at <= 350/mm(3) (adjusted-IRR = 3.82, 95% CI = 1.11-9.70) and 351-500/mm(3) (adjusted-IRR = 4.37, 95% CI = 0.98-13.02), but not >500/mm(3) (adjusted-IRR = 1.07, 95% CI = 0.01-4.91). Conclusion: Despite no effect of HBV-infection on CD4(+) levels, HIV-HBV co-infected individuals with high HBV replication are at higher risk of mortality when CD4(+) is <500/mm(3).

引用

页码：25 / 33

页数：9

共 34 条

[21] Impact of Hepatitis B Virus Infection on the Progression of AIDS and Mortality in HIV-Infected Individuals: A Cohort Study and Meta-Analysis [J].