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Antivir Ther. 2018;23(5):405-413. doi: 10.3851/IMP3218.

Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study.

Author information

1
CHIP, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
2
University College London Medical School, Primary Care and Population Sciences, London, United Kingdom.
3
London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, United Kingdom.
4
Hospital Universitario Ramón y Cajal-IRYCIS, Infectious Diseases Department, Madrid, Spain.
5
University Hospital Geneva, Geneva, Switzerland.
6
The Institute for Infectious & Tropical Diseases, Belgrade, Serbia.
7
Athens Medical School, Hippokration General Hospital, Athens, Greece.
8
Hopital Saint-Antoine, Paris, France.
9
CHU Saint-Pierre Hospital, Brussels, Belgium.
10
University of Bonn, Department of Medicine I, Bonn, Germany.
11
Narva AIDS Centre, Kohtla-Järve, Estonia.
12
Belarus State Medical University, Minsk, Belarus.
13
Uniwersytet Medyczny w Bialymstoku, Department of Infectious Diseases, Bialystok, Poland.
14
Klinicki Centar Univerziteta Sarajevo, Sarajevo, Bosnia & Herzegovina.
15
University of Iceland and Landspitali University Hospital, Reykjavik, Iceland.
16
Dr. Victor Babes Hospital, Spitalul de Boli Infectioase si Tropicale, Bucharest, Romania.
17
Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology, Nizhny Novgorod, Russia.
18
Royal London Hospital, London, United Kingdom.
19
Osp. L. Sacco, Milan, Italy.
20
Hospital Universitario de Alava, Vitoria-Gasteiz, Spain.

Abstract

BACKGROUND:

According to guidelines all HIV-HBV-coinfected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV-HBV patients in the EuroSIDA study.

METHODS:

All hepatitis B surface antigen (HBsAg)+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events.

RESULTS:

953 HIV-HBV patients were included. Median age was 41 years and patients were predominantly male (85%), White (82%) and ART-experienced (88%). 697 and 256 were from Western and Eastern Europe, respectively. 55 started cART during follow-up, the proportion starting with CD4+ T-cell count <350 cells/mm3 decreased from 85% to 52% in the periods 2002-2006 to 2007-2015. Tenofovir use, among those taking cART, increased from 4% in 2002 to 73% in 2015. Compared to West, tenofovir use was lower in East in 2005 (7% versus 42%), and remained lower in 2015 (63% versus 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. 27 of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas 10 started pegylated interferon. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (n=51), adjusted incidence rate ratio (IRR) 0.64 (95% CI 0.35, 1.18) for comparing patients on tenofovir with those off tenofovir.

CONCLUSIONS:

Although use of tenofovir-based cART among HIV-HBV patients has increased across Europe, a substantial proportion are still starting cART late and are receiving suboptimal HBV therapy.

PMID:
29303483
DOI:
10.3851/IMP3218

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