title: Management and treatment of chronic hepatitis B virus infection in HIV positive and negative patients: the EPIB 2008 study.
abstract: OBJECTIVE
  To compare the management and the virological and serological efficacy of treatments for chronic hepatitis B (CHB) in HIV positive and negative patients.
  
  
  METHODS
  Two hundred and forty-six HIV positive and 205 HIV negative consecutive patients with past or present CHB, seen in October 2008 in participating departments, were included in a multicenter study. All the data were retrospectively collected from the first visit to October 2008 through a standardized questionnaire.
  
  
  RESULTS
  Compared to HIV negative patients, HIV positive patients more often presented positive HBeAg (46.4% vs. 32.8%, p=0.01), HBV genotype A (54.8% vs. 17.1%, p<0.0001), co-infection with HCV (12.4% vs. 5.9%, p=0.0002) or HDV (12.6% vs. 2.9%, p=0.04). HIV positive patients were more often on HBV therapy (92.7% vs. 57.1%, p<0.0001), leading to undetectable serum HBV DNA levels (71.0% vs. 44.1%, p<0.0001). In HIV positive patients, multivariate analysis showed that older age, lower initial HBV DNA levels, and longer time on HBV therapy significantly correlated with undetectable HBV DNA. No difference in efficacy was observed between tenofovir used alone or in combination. HBsAg (but not HBe) loss was more often observed in HIV positive patients, sometimes followed by HBsAg re-appearance after withdrawal of HBV treatment. Excluding the 37 HBV-HCV-co-infected patients, the last clinical presentation and liver fibrosis scores were similar in HIV positive and negative patients.
  
  
  CONCLUSIONS
  The assessment of CHB and the efficacy of HBV therapy have improved in HIV positive patients. HIV infection did not have a negative impact on the likelihood of HBV therapeutic success.
authors.affiliation: Service de Maladies Infectieuses et Tropicales, CHU Dijon and Université de Bourgogne, France. lionel.piroth@chu-dijon.fr
authors.forename: Lionel
authors.initials: L
authors.lastname: Piroth
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.forename: Patrick
authors.initials: P
authors.lastname: Miailhes
authors.forename: Agathe
authors.initials: A
authors.lastname: Rami
authors.forename: David
authors.initials: D
authors.lastname: Rey
authors.forename: Veronique
authors.initials: V
authors.lastname: Loustau-Ratti
authors.forename: Philippe
authors.initials: P
authors.lastname: Morlat
authors.forename: Isabelle
authors.initials: I
authors.lastname: Goderel
authors.forename: Damien
authors.initials: D
authors.lastname: Sene
authors.forename: Eric
authors.initials: E
authors.lastname: Rosenthal
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications*; D006510:Hepatitis B Antibodies / Q000097:blood; D006511:Hepatitis B Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D000068698:Tenofovir
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine