title: Therapeutic management and evolution of chronic hepatitis B: does HIV still have an impact? The EPIB 2012 study.
abstract: OBJECTIVE
  To compare the management of chronic hepatitis B (CHB) and its evolution over time in currently followed HIV-positive and HIV-negative patients.
  
  
  METHODS
  A total of 709 consecutive patients with past or present positive HBs antigenemia seen in October 2012 in 19 French participating centres were included. The data were retrospectively collected from the first visit onwards through standardized questionnaires.
  
  
  RESULTS
  Chronic hepatitis B was less often assessed in the 299 HIV-positive patients, who were older, more likely to be male, excessive alcohol drinkers and HBe antigen-, HCV- and HDV-positive. They were also followed up for a longer time (11.3 +/-8.8 vs. 8.6 +/-6.9 years, P < 10(-3) ) and were more frequently treated for HBV (95.3% vs. 56.8%, P < 10(-3) ). HBV was undetectable at the last visit in 80.8% of HIV-positive vs. 55.1% of HIV-negative patients (P < 10(-3) ). In multivariate analyses, undetectable HBV was significantly associated with older age, lower baseline HBV DNA, longer HBV therapy and no previous lamivudine monotherapy, but not with HIV. Cirrhosis was associated with age, male gender, Asian origin, alcoholism, HCV, HDV, but not with HIV infection. Hepatocellular carcinoma, less frequently observed in HIV-positive patients (0.7% vs. 4.7%, P = 0.002), was positively associated with age, male gender, cirrhosis and negatively associated with HIV infection (OR 0.15, 95%CI 0.03-0.67, P = 0.01).
  
  
  CONCLUSIONS
  Although the assessment of CHB still has to be improved in HIV-positive patients, the negative impact of HIV on the virological, histological and clinical evolution of CHB seems to be disappearing, probably because of the immunovirological impact of HAART and the more frequent and longer use of HBV therapy.
authors.affiliation: Infectious Diseases Department, CHU and UMR 1347, University of Burgundy, Dijon, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Piroth
authors.affiliation: Institut Pasteur, INSERM UMS 20, Service d'Hépatologie, Université Paris Descartes and APHP, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.affiliation: Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales and INSERM U1052, Lyon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Miailhes
authors.affiliation: Infectious Diseases Department, CHU and UMR-S707, University Pierre and Marie Curie, Paris, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.affiliation: Université Paris Diderot and AP-HP Service de Medecine Interne A, Paris, France.
authors.forename: Amanda
authors.initials: A
authors.lastname: Lopes
authors.affiliation: Infectious Diseases Department, CHU and UMR 1347, University of Burgundy, Dijon, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Fillion
authors.affiliation: Federation of Hepatology CHU Limoges and Inserm UMR 1092, University of Limoges, Limoges, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Loustaud-Ratti
authors.affiliation: Infectious Diseases Department, CHU Rouen, Rouen, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Borsa-Lebas
authors.affiliation: Cochin Hospital, Infectious Pathology unit, Paris Descartes University, Infectious Pathology unit, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon
authors.affiliation: Department of internal medicine, CHU De Nice and University of Nice Sophia Antipolis, Nice, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Rosenthal
authors.affiliation: UPMC Université Paris 06, UMR-S707, INSERM U-707, AP-HP, Public Health Department, Paris, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
authors.affiliation: Departement Hospitalo Universitaire I2B, UPMC Université Paris 06, Paris, France.|UMR 7211, INSERM, UMR_S 959, Paris, France.|CNRS, UMR 7211, Paris, France.|Department of Internal Medicine, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005602:France / Q000453:epidemiology; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D018023:HIV Seronegativity / Q000276:immunology; D006679:HIV Seropositivity / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D000068698:Tenofovir / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir
keywords: HBV; HIV; cirrhosis; entecavir; hepatocellular carcinoma; tenofovir