HIV-HBV coinfection: immunological efficacy of tenofovir disproxil fumarate-containing regimens

  • Jiang T & al.
  • Front Pharmacol
  • 1 Jan 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with human immunodeficiency virus (HIV)-hepatitis B virus (HBV) co-infection, tenofovir disproxil fumarate (TDF)-containing regimens were effective at stimulating hepatitis B envelope antigen (HBeAg) loss, HBeAg conversion, HBV surface antigen (HBsAg) loss, and HBsAg conversion.
  • Findings should be interpreted with caution because of significant heterogeneity across all study arms.

Why this matters

  • Randomised controlled trials (RCTs) with large sample sizes are required for the investigation of potential predictors and biological markers associated with strategies for achieving HBV remission in patients with HIV-HBV coinfection.

Study design

  • Meta-analysis included 11 studies (3 RCTs and 8 prospective cohort studies) after a search across electronic databases.
  • Funding: The National 13th Five-Year Grand Program on Key Infectious Disease Control and others.

Key results

  • TDF-based regimens were effective at stimulating:
    • HBeAg loss (event rate [ER], 0.249; 95% CI, 0.155-0.376; I2, 55.78%) and conversion (ER, 0.237; 95% CI, 0.145-0.376; P<.001 for both and>
    • HBsAg loss (ER, 0.073; 95% CI, 0.044-0.119) and conversion (ER, 0.055; 95% CI, 0.02-0.142; P<.001 for both>
  • Baseline HBV viral load, participant’s location and a history of exposure to lamivudine/emtricitabine were associated with HBsAg loss (P<.05 for all>
  • A negative association was observed between the baseline CD4+ T-cell count and HBsAg loss (P=.078).

Limitations

  • High level of heterogeneity.