title: Treatment outcomes in a cohort of patients with chronic hepatitis B and human immunodeficiency virus co-infection in Mumbai, India.
abstract: Treatment experiences with patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in resource-limited settings remain poorly documented. This study aimed to evaluate the treatment outcomes in a cohort of HIV/HBV co-infected individuals receiving tenofovir/lamivudine (TDF/3TC)-based antiretroviral therapy (ART) in a programmatic setting in Mumbai, India. Additionally, a cross-sectional laboratory study was carried out measuring serologic and virologic parameters. A total of 57 patients who received TDF/3TC were included in the study. Of these, 52 (91%) were male and the mean age was 38.7 years. The median follow-up period was 16.8 months (IQR:7.9-37.9). Forty-three patients were included in the cross-sectional laboratory study, of whom 38 (67%) were HBeAg(+) positive. Four patients had serum HBsAg conversion to negative and had developed anti-HBs-antibodies. HBV-DNA became undetectable (<1.3 log10 copies/ml or <20 IU/ml) in 35.5% and 75% of the HBeAg(+) and HBeAg(-) patients, respectively. Overall, 46.5% of patients had undetectable HBV-DNA and 90.7% had adequately suppressed HBV-DNA (<3.3 log10 copies/ml or <2000 IU/ml). The median reduction in serum HBV-DNA was 6 log10 copies/ml. In 29 patients (63%) HIV viral load was undetectable. Outcomes included seven (12%) deaths, four (7%) lost to follow-up, one (2%) transferred out and 45 (79%) alive and on treatment. In conclusion, good treatment outcomes were achieved in a cohort of HIV/HBV co-infected patients in India. In regions with a high HIV/HBV burden, all HIV-infected individuals should be tested for chronic hepatitis B. A TDF/3TC-backbone could be considered as first-line standardized ART regimen in these settings.
authors.affiliation: Médecins Sans Frontières, Chandni Bungalow, 1st floor, Union Park, Off Carter Road, Khar West, Mumbai 400 052, India.
authors.forename: Petros
authors.initials: P
authors.lastname: Isaakidis
authors.forename: Homa
authors.initials: H
authors.lastname: Mansoor
authors.forename: Rony
authors.initials: R
authors.lastname: Zachariah
authors.forename: Esdras A
authors.initials: EA
authors.lastname: Da Silva
authors.forename: Bhanumati
authors.initials: B
authors.lastname: Varghese
authors.forename: Alaka
authors.initials: A
authors.lastname: Deshpande
authors.forename: Tiago A
authors.initials: TA
authors.lastname: Dal Molin
authors.forename: Joanna
authors.initials: J
authors.lastname: Ladomirska
authors.forename: Line
authors.initials: L
authors.lastname: Arnould
authors.forename: Tony
authors.initials: T
authors.lastname: Reid