objectives the aim of this analysis was to investigate the impact of hepatitis B virus (HBV) coinfection on the risk of HIV viral rebound (VR) after achieving suppression for the first time following initiation of antiretroviral therapy (ART) in the real-world setting. design patients living with HIV (PLWH) who were enrolled in the ICONA foundation study cohort and achieved viral suppression <= 50 copies/mL for the first time after starting ART were prospectively evaluated and divided in three exposure groups according to serology test results: (a) HIV-monoinfected; (b) HIV-positive/HBcAb-positive/HBsAg-negative; (c) HIV-positive/HBsAg-positive. the occurrence of VR, defined as two consecutive HIV-RNA values >50 copies/mL after achieving viral suppression for the first time (baseline), was investigated. methods standard survival analysis by means of kaplan-meier curves and cox regression analysis with the serology exposure fitted as a time-fixed covariate measured at baseline was employed after controlling for key confounding factors. results of a total of 5657 patients included, 4090 (72%) were HIV-monoinfected, 1342 (23.7%)were HBcAb-positive, and 225 (3.9%) were HbsAg-positive coinfected. overall, 654 (11.5%) PLWH experienced VR > 50 copies/mL during follow-up. after controlling for all sources of measured confounding, coinfected PLWH showed an increased risk of experiencing VR compared with those who were HIV-monoinfected. In particular, the strongest associations were seen for the HIV/HBsAg-positive participants [adjusted hazard ratio (aHR) = 1.56, 95% confidence interval (CI): 1.03-2.38, p = 0.037] but an excess of risk was also seen in those who were HIV-positive/HBcAb-positive/HBsAg-negative (aHR = 1.25, 95% CI: 1.00-1.55, p = 0.047). conclusions coinfection with HBV seems to have an impact on the probability of maintaining HIV viral suppression achieved for the first time after ART initiation. of note, even PLWH positive for HBcAb, a marker of inactive HBV infection, appeared to be at higher risk of VR compared with those who were HIV-monoinfected and their HIV-RNA should be carefully monitored.

Malagnino, V., Cozzi‐lepri, A., Svicher, V., Girardi, E., Perno, C., Saracino, A., et al. (2024). Association between markers of hepatitis B virus infection and risk of virological rebound in people with HIV receiving antiretroviral therapy. HIV MEDICINE, 25(10), 1101-1111 [10.1111/hiv.13680].

Association between markers of hepatitis B virus infection and risk of virological rebound in people with HIV receiving antiretroviral therapy

Vincenzo Malagnino;Alessandro Cozzi‐Lepri;Valentina Svicher;Carlo Federico Perno;Massimo Andreoni;Loredana Sarmati
2024-01-01

Abstract

objectives the aim of this analysis was to investigate the impact of hepatitis B virus (HBV) coinfection on the risk of HIV viral rebound (VR) after achieving suppression for the first time following initiation of antiretroviral therapy (ART) in the real-world setting. design patients living with HIV (PLWH) who were enrolled in the ICONA foundation study cohort and achieved viral suppression <= 50 copies/mL for the first time after starting ART were prospectively evaluated and divided in three exposure groups according to serology test results: (a) HIV-monoinfected; (b) HIV-positive/HBcAb-positive/HBsAg-negative; (c) HIV-positive/HBsAg-positive. the occurrence of VR, defined as two consecutive HIV-RNA values >50 copies/mL after achieving viral suppression for the first time (baseline), was investigated. methods standard survival analysis by means of kaplan-meier curves and cox regression analysis with the serology exposure fitted as a time-fixed covariate measured at baseline was employed after controlling for key confounding factors. results of a total of 5657 patients included, 4090 (72%) were HIV-monoinfected, 1342 (23.7%)were HBcAb-positive, and 225 (3.9%) were HbsAg-positive coinfected. overall, 654 (11.5%) PLWH experienced VR > 50 copies/mL during follow-up. after controlling for all sources of measured confounding, coinfected PLWH showed an increased risk of experiencing VR compared with those who were HIV-monoinfected. In particular, the strongest associations were seen for the HIV/HBsAg-positive participants [adjusted hazard ratio (aHR) = 1.56, 95% confidence interval (CI): 1.03-2.38, p = 0.037] but an excess of risk was also seen in those who were HIV-positive/HBcAb-positive/HBsAg-negative (aHR = 1.25, 95% CI: 1.00-1.55, p = 0.047). conclusions coinfection with HBV seems to have an impact on the probability of maintaining HIV viral suppression achieved for the first time after ART initiation. of note, even PLWH positive for HBcAb, a marker of inactive HBV infection, appeared to be at higher risk of VR compared with those who were HIV-monoinfected and their HIV-RNA should be carefully monitored.
2024
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MEDS-10/B - Malattie infettive
English
ART
HBcAb
HIV rebound
HIV/HBV
occult hepatitis B infection
Malagnino, V., Cozzi‐lepri, A., Svicher, V., Girardi, E., Perno, C., Saracino, A., et al. (2024). Association between markers of hepatitis B virus infection and risk of virological rebound in people with HIV receiving antiretroviral therapy. HIV MEDICINE, 25(10), 1101-1111 [10.1111/hiv.13680].
Malagnino, V; Cozzi‐lepri, A; Svicher, V; Girardi, E; Perno, C; Saracino, A; Cuomo, G; Rusconi, S; Puoti, M; D'Arminio Monforte, A; Andreoni, M; Sarma...espandi
Articolo su rivista
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/387563
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact