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Hepatitis B serological markers and plasma DNA concentrations
OBJECTIVES: To examine hepatitis B (HBV) serological markers and plasma DNA concentrations in a large group of untreated HBV/HIV-coinfected individuals in two sub-Saharan settings. DESIGN: Baseline analysis of a randomized controlled trial. METHODS: DART was a large trial of treatment monitoring pra...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414544/ https://www.ncbi.nlm.nih.gov/pubmed/28328795 http://dx.doi.org/10.1097/QAD.0000000000001454 |
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author | Price, Huw Dunn, David Zachary, Tamale Vudriko, Tobias Chirara, Michael Kityo, Cissy Munderi, Paula Spyer, Moira Hakim, James Gilks, Charles Kaleebu, Pontiano Pillay, Deenan Gilson, Richard |
author_facet | Price, Huw Dunn, David Zachary, Tamale Vudriko, Tobias Chirara, Michael Kityo, Cissy Munderi, Paula Spyer, Moira Hakim, James Gilks, Charles Kaleebu, Pontiano Pillay, Deenan Gilson, Richard |
author_sort | Price, Huw |
collection | PubMed |
description | OBJECTIVES: To examine hepatitis B (HBV) serological markers and plasma DNA concentrations in a large group of untreated HBV/HIV-coinfected individuals in two sub-Saharan settings. DESIGN: Baseline analysis of a randomized controlled trial. METHODS: DART was a large trial of treatment monitoring practices in HIV-infected adults with advanced disease starting antiretroviral therapy at centres in Kampala or Entebbe, Uganda (n = 2317) and Harare, Zimbabwe (n = 999). HBV serological markers [antibody to HBV core antigen, HBV surface antigen (HBsAg), antibody to HBV surface antigen, HBV ‘e’ antigen (HBeAg), and antibody to hepatitis B ‘e’ antigen] and plasma HBV DNA viral load were measured retrospectively on stored baseline samples. Logistic regression was used to examine associations with baseline demographic and clinical factors. RESULTS: The rate of HBsAg positivity was significantly higher in Zimbabwe than Uganda (12.2 vs. 7.7%, adjusted odds ratio = 1.54, P < 0.001) despite a similar prevalence of antibody to HBV core antigen (56.3 vs. 52.4%) in the two settings. Overall, HBsAg positivity was associated with male sex (adjusted odds ratio = 1.54, P < 0.001) but not with age, WHO disease stage, or CD4(+) cell count. HBeAg was detected among 37% of HBsAg-positive patients, with higher rates among those with advanced WHO stage (P = 0.02). Also in HBsAg-positive patients, HBV DNA was undetectable in 21%, detectable but below the level of quantification in 14%, and quantifiable in 65%. A total of 96% of HBeAg-positive and 70% of HBeAg-negative patients had detectable HBV DNA; 92 and 28% of patients, respectively, had HBV DNA viral load more than 2000 IU/ml. CONCLUSION: High rates of HBV coinfection were observed, highlighting the importance of ensuring that coinfected patients receive an antiretroviral regimen, whether first-line or not, that is active against both viruses. |
format | Online Article Text |
id | pubmed-5414544 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-54145442017-05-10 Hepatitis B serological markers and plasma DNA concentrations Price, Huw Dunn, David Zachary, Tamale Vudriko, Tobias Chirara, Michael Kityo, Cissy Munderi, Paula Spyer, Moira Hakim, James Gilks, Charles Kaleebu, Pontiano Pillay, Deenan Gilson, Richard AIDS Clinical Science OBJECTIVES: To examine hepatitis B (HBV) serological markers and plasma DNA concentrations in a large group of untreated HBV/HIV-coinfected individuals in two sub-Saharan settings. DESIGN: Baseline analysis of a randomized controlled trial. METHODS: DART was a large trial of treatment monitoring practices in HIV-infected adults with advanced disease starting antiretroviral therapy at centres in Kampala or Entebbe, Uganda (n = 2317) and Harare, Zimbabwe (n = 999). HBV serological markers [antibody to HBV core antigen, HBV surface antigen (HBsAg), antibody to HBV surface antigen, HBV ‘e’ antigen (HBeAg), and antibody to hepatitis B ‘e’ antigen] and plasma HBV DNA viral load were measured retrospectively on stored baseline samples. Logistic regression was used to examine associations with baseline demographic and clinical factors. RESULTS: The rate of HBsAg positivity was significantly higher in Zimbabwe than Uganda (12.2 vs. 7.7%, adjusted odds ratio = 1.54, P < 0.001) despite a similar prevalence of antibody to HBV core antigen (56.3 vs. 52.4%) in the two settings. Overall, HBsAg positivity was associated with male sex (adjusted odds ratio = 1.54, P < 0.001) but not with age, WHO disease stage, or CD4(+) cell count. HBeAg was detected among 37% of HBsAg-positive patients, with higher rates among those with advanced WHO stage (P = 0.02). Also in HBsAg-positive patients, HBV DNA was undetectable in 21%, detectable but below the level of quantification in 14%, and quantifiable in 65%. A total of 96% of HBeAg-positive and 70% of HBeAg-negative patients had detectable HBV DNA; 92 and 28% of patients, respectively, had HBV DNA viral load more than 2000 IU/ml. CONCLUSION: High rates of HBV coinfection were observed, highlighting the importance of ensuring that coinfected patients receive an antiretroviral regimen, whether first-line or not, that is active against both viruses. Lippincott Williams & Wilkins 2017-05-15 2017-04-25 /pmc/articles/PMC5414544/ /pubmed/28328795 http://dx.doi.org/10.1097/QAD.0000000000001454 Text en Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | Clinical Science Price, Huw Dunn, David Zachary, Tamale Vudriko, Tobias Chirara, Michael Kityo, Cissy Munderi, Paula Spyer, Moira Hakim, James Gilks, Charles Kaleebu, Pontiano Pillay, Deenan Gilson, Richard Hepatitis B serological markers and plasma DNA concentrations |
title | Hepatitis B serological markers and plasma DNA concentrations |
title_full | Hepatitis B serological markers and plasma DNA concentrations |
title_fullStr | Hepatitis B serological markers and plasma DNA concentrations |
title_full_unstemmed | Hepatitis B serological markers and plasma DNA concentrations |
title_short | Hepatitis B serological markers and plasma DNA concentrations |
title_sort | hepatitis b serological markers and plasma dna concentrations |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414544/ https://www.ncbi.nlm.nih.gov/pubmed/28328795 http://dx.doi.org/10.1097/QAD.0000000000001454 |
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