Intensification with pegylated interferon during treatment with tenofovir in HIV–hepatitis B virus co‐infected patients |
| |
| Authors: | A. Boyd L. Piroth S. Maylin M. Maynard‐Muet F. Lebossé C. Bouix C. Lascoux‐Combe N. Mahjoub P.‐M. Girard C. Delaugerre F. Carrat K. Lacombe P. Miailhes |
| |
| Affiliation: | 1. INSERM, UMR_S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France;2. Département d'Infectiologie, CHU and UMR 1347, Université de Bourgogne, Dijon, France;3. Laboratoire de Virologie, H?pital Saint‐Louis, AP‐HP, Paris, France;4. Université Paris‐Diderot, Paris, France;5. Service d'Hépatologie, H?pital Croix‐Rousse, Hospices Civils de Lyon, INSERM U1052, Lyon, France;6. Service des Maladies Infectieuses et Tropicales, H?pital Saint‐Louis, AP‐HP, Paris, France;7. Service des Maladies Infectieuses et Tropicales, H?pital Saint‐Antoine, AP‐HP, Paris, France;8. Institut Pierre Louis d'Epidémiologie et de Santé Publique, UPMC Univ Paris 06, UMR_S 1136, Sorbonne Universités, Paris, France;9. INSERM U941, Paris, France;10. Département de Santé Publique, H?pital Saint‐Antoine, AP‐HP, Paris, France;11. Centre de Recherche sur le Cancer de Lyon, Equipes 15 et 16, INSERM, Unité 1052, UMR 5286, CNRS, Lyon, France;12. Service des Maladies Infectieuses et Tropicales, H?pital de la Croix‐Rousse, Hospices Civils de Lyon, Lyon, France |
| |
| Abstract: | In hepatitis B “e” antigen (HBeAg) positive patients with hepatitis B virus (HBV) mono‐infection, intensification of nucleos(t)ide analogue treatment with pegylated interferon (PegIFN) could help induce higher HBeAg seroclearance rates. Our aim was to determine the long‐term effect of adding PegIFN to tenofovir (TDF)‐containing antiretroviral therapy on seroclearance in HBeAg‐positive patients co‐infected with the human immunodeficiency virus (HIV) and HBV. In this prospective matched cohort study, 46 patients with 1‐year PegIFN intensification during TDF‐containing antiretroviral therapy (TDF+PegIFN) were matched 1:1 to controls undergoing TDF without PegIFN (TDF) using a time‐dependent propensity score based on age, CD4+ count and liver cirrhosis status. Kinetics of HBeAg quantification (qHBeAg) and hepatitis B surface antigen quantification (qHBsAg) were estimated using mixed‐effect linear regression and time to HBeAg seroclearance or HBsAg seroclearance was modelled using proportional hazards regression. At baseline, previous TDF exposure was a median 39.8 months (IQR=21.4–59.4) and median qHBeAg and qHBsAg levels were 6.9 PEIU/mL and 3.72 log10IU/mL, respectively (P>.5 between groups). Median follow‐up was 33.4 months (IQR=19.0–36.3). During intensification, faster average declines of qHBeAg (?0.066 vs ?0.027 PEIU/mL/month, P=.001) and qHBsAg (?0.049 vs ?0.026 log10IU/mL/month, P=.09) were observed in patients undergoing TDF+PegIFN vs TDF, respectively. After intensification, qHBeAg and qHBsAg decline was no different between groups (P=.7 and P=.9, respectively). Overall, no differences were observed in HBeAg seroclearance (TDF+PegIFN=13.2 vs TDF=12.6/100 person·years, P=.5) or HBsAg seroclearance rates (TDF+PegIFN=1.8 vs TDF=1.3/100 person·years, P=.7). In conclusion, PegIFN intensification in HBeAg‐positive co‐infected patients did not lead to increased rates of HBeAg or HBsAg clearance, despite faster declines of antigen levels while on PegIFN. |
| |
| Keywords: | chronic hepatitis B infection
HIV
pegylated interferon time‐dependent propensity score treatment intensification |
|
|
