An evaluation of hepatitis B virus diagnostic methods and responses to antiretroviral therapy among HIV-infected women in Thailand

J Int Assoc Provid AIDS Care. 2013 Sep-Oct;12(5):349-53. doi: 10.1177/2325957413488201. Epub 2013 Jun 21.

Abstract

Coinfection with HIV and hepatitis B virus (HBV) is common in resource-limited settings but is frequently not diagnosed. The authors retrospectively tested specimens for HBV in HIV-infected Thai women who had participated in an antiretroviral therapy (ART) clinical study. A substantial proportion (27 of 211; 13%) of HIV-infected women were HBV coinfected. Among HIV/HBV-coinfected women, the authors observed similar rates of antiretroviral-associated liver toxicity (despite nevirapine [NVP] use) and CD4 count reconstitution as observed in HIV-monoinfected women. Hepatitis B surface antigen (HBsAg) screening detected the majority (81%) of HBV coinfections, including all 5 HBV-coinfected women who did not suppress HBV despite 48 weeks of lamivudine (3TC)-containing ART and could be used to tailor ART for patients diagnosed with HBV coinfection in accordance with World Health Organization guidelines. Although HBsAg screening did not diagnose 5 occult HBV coinfections, these women achieved HBV suppression on 3TC-containing ART, suggesting that not detecting occult HBV coinfection would have limited clinical impact.

Keywords: HIV; hepatitis B virus; lamivudine.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Coinfection / diagnosis*
  • Coinfection / drug therapy
  • Coinfection / virology
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / virology*
  • Hepatitis B / diagnosis*
  • Hepatitis B / virology*
  • Hepatitis B virus / drug effects
  • Humans
  • Lamivudine / therapeutic use
  • Retrospective Studies
  • Thailand
  • Viral Load / drug effects

Substances

  • Anti-Retroviral Agents
  • Lamivudine