title: Slow CD4+T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana.
abstract: Background.Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection has emerged as an important cause of morbidity and mortality. We determined the response to Truvada-based first-line combination antiretroviral therapy (cART) in HIV/HBV-coinfected verus HIV-monoinfected patients in Botswana.Methods.Hepatitis B virus surface antigen (HBsAg), HBV e antigen (HBeAg), and HBV deoxyribonucleic acid (DNA) load were determined from baseline and follow-up visits in a longitudinal cART cohort of Truvada-based regimen. We assessed predictors of HBV serostatus and viral suppression (undetectable HBV DNA) using logistic regression techniques.Results.Of 300 participants, 28 were HBsAg positive, giving an HIV/HBV prevalence of 9.3% (95% confidence interval [CI], 6.3-13.2), and 5 of these, 17.9% (95% CI, 6.1-36.9), were HBeAg positive. There was a reduced CD4+T-cell gain in HIV/HBV-coinfected compared with HIV-monoinfected patients. Hepatitis B virus surface antigen and HBeAg loss was 38% and 60%, respectively, at 24 months post-cART initiation. The HBV DNA suppression rates increased with time on cART from 54% to 75% in 6 and 24 months, respectively.Conclusions.Human immunodeficiency virus/HBV coinfection negatively affected immunologic recovery compared with HIV-1C monoinfection. Hepatitis B virus screening before cART initiation could help improve HBV/HIV treatment outcomes and help determine treatment options when there is a need to switch regimens.
authors: Botswana Harvard AIDS Institute Partnership; Department of Biological Sciences, University of Botswana, Gaborone.
authors: Motswedi
authors: M
authors: Anderson
authors: Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors: Simani
authors: S
authors: Gaseitsiwe
authors: Botswana Harvard AIDS Institute Partnership; Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, South Africa.
authors: Sikhulile
authors: S
authors: Moyo
authors: Botswana Harvard AIDS Institute Partnership.
authors: Kerapetse P
authors: KP
authors: Thami
authors: Botswana Harvard AIDS Institute Partnership; Department of Biological Sciences, University of Botswana, Gaborone.
authors: Terence
authors: T
authors: Mohammed
authors: Botswana Harvard AIDS Institute Partnership.
authors: Ditiro
authors: D
authors: Setlhare
authors: Department of Biological Sciences , University of Botswana , Gaborone.
authors: Theresa K
authors: TK
authors: Sebunya
authors: University of Cincinnati College of Medicine , Ohio.
authors: Eleanor A
authors: EA
authors: Powell
authors: Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors: Joseph
authors: J
authors: Makhema
authors: University of Cincinnati College of Medicine , Ohio.
authors: Jason T
authors: JT
authors: Blackard
authors: Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors: Richard
authors: R
authors: Marlink
authors: Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors: Max
authors: M
authors: Essex
authors: Botswana Harvard AIDS Institute Partnership; Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors: Rosemary M
authors: RM
authors: Musonda
keywords: Botswana; HIV/HBV coinfection; Truvada; hepatitis B virus; tenofovir