Tenofovir-based antiretroviral therapy in HBV-HIV coinfection: Results from the treat Asia HIV Observational Database

David C. Boettiger, Stephen Kerr, Rossana Ditangco, Romanee Chaiwarith, Patrick C.K. Li, Tuti Parwati Merati, Thuy Thi Thanh Pham, Sasisopin Kiertiburanakul, Nagalingeswaran Kumarasamy, Saphonn Vonthanak, Christopher K.C. Lee, Nguyen Van Kinh, Sanjay Pujari, Wing Wai Wong, Adeeba Kamarulzaman, Fujie Zhang, Evy Yunihastuti, Jun Yong Choi, Shinichi Oka, Oon Tek NgPacharee Kantipong, Mahiran Mustafa, Winai Ratanasuwan, Nicolas Durier, Matthew Law

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The World Health Organization recommends HBV-HIV-coinfected individuals start antiretroviral therapy containing tenofovir. Here we describe irst-line tenofovir use and treatment outcomes in coinfected patients in Asia. Methods: HBV surface antigen positive patients enrolled in the TREAT Asia HIV Observational Database who started irst-line antiretroviral therapy were included. Logistic regression adjusted for period of treatment initiation was used to determine factors associated with tenofovir use. Generalized estimating equations were used to evaluate factors associated with alanine transaminase levels and CD4+ T-cell count on treatment. Results: There were 548 eligible patients, of whom 149 (27.2%) started tenofovir. Patients treated in high/highmiddle income countries (odds ratio 4.4 versus low/lowmiddle, 95% CI 2.6, 7.4; P<0.001) and those with elevated baseline alanine transaminase (odds ratio 4.2 versus normal, 95% CI 2.4, 7.2; P<0.001) were more likely to receive tenofovir. Hepatitis C antibody positive patients (odds ratio 0.4 versus negative, 95% CI 0.2, 0.8; P=0.008) were less likely. In those starting antiretroviral therapy with elevated alanine transaminase, mean reduction after tenofovir initiation was 11.2 IU/l (95% CI 0.9, 21.6; P=0.034) lower compared with those using a non-tenofovir-based regimen although this did not signiicantly increase the chance of alanine transaminase normalization. Tenofovir use was not associated with a superior CD4+ T-cell response. Conclusions: HBV-HIV-coinfected patients in Asia are most likely to receive tenofovir if they are treated in a high/highmiddle income country, have elevated alanine transaminase levels and are hepatitis C antibody negative. Compared to other antiretroviral therapies, tenofovir-based regimens more effectively reduce liver inlammation in HBV-HIV-coinfection but do not result in superior CD4+ T-cell recovery.

Original languageEnglish
Pages (from-to)27-35
Number of pages9
JournalAntiviral therapy
Volume21
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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Tenofovir
Coinfection
HIV
Databases
Alanine Transaminase
Hepatitis C Antibodies
Therapeutics
Odds Ratio
T-Lymphocytes

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Boettiger, D. C., Kerr, S., Ditangco, R., Chaiwarith, R., Li, P. C. K., Merati, T. P., ... Law, M. (2016). Tenofovir-based antiretroviral therapy in HBV-HIV coinfection: Results from the treat Asia HIV Observational Database. Antiviral therapy, 21(1), 27-35. https://doi.org/10.3851/IMP2972
Boettiger, David C. ; Kerr, Stephen ; Ditangco, Rossana ; Chaiwarith, Romanee ; Li, Patrick C.K. ; Merati, Tuti Parwati ; Pham, Thuy Thi Thanh ; Kiertiburanakul, Sasisopin ; Kumarasamy, Nagalingeswaran ; Vonthanak, Saphonn ; Lee, Christopher K.C. ; Van Kinh, Nguyen ; Pujari, Sanjay ; Wong, Wing Wai ; Kamarulzaman, Adeeba ; Zhang, Fujie ; Yunihastuti, Evy ; Choi, Jun Yong ; Oka, Shinichi ; Ng, Oon Tek ; Kantipong, Pacharee ; Mustafa, Mahiran ; Ratanasuwan, Winai ; Durier, Nicolas ; Law, Matthew. / Tenofovir-based antiretroviral therapy in HBV-HIV coinfection : Results from the treat Asia HIV Observational Database. In: Antiviral therapy. 2016 ; Vol. 21, No. 1. pp. 27-35.
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abstract = "Background: The World Health Organization recommends HBV-HIV-coinfected individuals start antiretroviral therapy containing tenofovir. Here we describe irst-line tenofovir use and treatment outcomes in coinfected patients in Asia. Methods: HBV surface antigen positive patients enrolled in the TREAT Asia HIV Observational Database who started irst-line antiretroviral therapy were included. Logistic regression adjusted for period of treatment initiation was used to determine factors associated with tenofovir use. Generalized estimating equations were used to evaluate factors associated with alanine transaminase levels and CD4+ T-cell count on treatment. Results: There were 548 eligible patients, of whom 149 (27.2{\%}) started tenofovir. Patients treated in high/highmiddle income countries (odds ratio 4.4 versus low/lowmiddle, 95{\%} CI 2.6, 7.4; P<0.001) and those with elevated baseline alanine transaminase (odds ratio 4.2 versus normal, 95{\%} CI 2.4, 7.2; P<0.001) were more likely to receive tenofovir. Hepatitis C antibody positive patients (odds ratio 0.4 versus negative, 95{\%} CI 0.2, 0.8; P=0.008) were less likely. In those starting antiretroviral therapy with elevated alanine transaminase, mean reduction after tenofovir initiation was 11.2 IU/l (95{\%} CI 0.9, 21.6; P=0.034) lower compared with those using a non-tenofovir-based regimen although this did not signiicantly increase the chance of alanine transaminase normalization. Tenofovir use was not associated with a superior CD4+ T-cell response. Conclusions: HBV-HIV-coinfected patients in Asia are most likely to receive tenofovir if they are treated in a high/highmiddle income country, have elevated alanine transaminase levels and are hepatitis C antibody negative. Compared to other antiretroviral therapies, tenofovir-based regimens more effectively reduce liver inlammation in HBV-HIV-coinfection but do not result in superior CD4+ T-cell recovery.",
author = "Boettiger, {David C.} and Stephen Kerr and Rossana Ditangco and Romanee Chaiwarith and Li, {Patrick C.K.} and Merati, {Tuti Parwati} and Pham, {Thuy Thi Thanh} and Sasisopin Kiertiburanakul and Nagalingeswaran Kumarasamy and Saphonn Vonthanak and Lee, {Christopher K.C.} and {Van Kinh}, Nguyen and Sanjay Pujari and Wong, {Wing Wai} and Adeeba Kamarulzaman and Fujie Zhang and Evy Yunihastuti and Choi, {Jun Yong} and Shinichi Oka and Ng, {Oon Tek} and Pacharee Kantipong and Mahiran Mustafa and Winai Ratanasuwan and Nicolas Durier and Matthew Law",
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Boettiger, DC, Kerr, S, Ditangco, R, Chaiwarith, R, Li, PCK, Merati, TP, Pham, TTT, Kiertiburanakul, S, Kumarasamy, N, Vonthanak, S, Lee, CKC, Van Kinh, N, Pujari, S, Wong, WW, Kamarulzaman, A, Zhang, F, Yunihastuti, E, Choi, JY, Oka, S, Ng, OT, Kantipong, P, Mustafa, M, Ratanasuwan, W, Durier, N & Law, M 2016, 'Tenofovir-based antiretroviral therapy in HBV-HIV coinfection: Results from the treat Asia HIV Observational Database', Antiviral therapy, vol. 21, no. 1, pp. 27-35. https://doi.org/10.3851/IMP2972

Tenofovir-based antiretroviral therapy in HBV-HIV coinfection : Results from the treat Asia HIV Observational Database. / Boettiger, David C.; Kerr, Stephen; Ditangco, Rossana; Chaiwarith, Romanee; Li, Patrick C.K.; Merati, Tuti Parwati; Pham, Thuy Thi Thanh; Kiertiburanakul, Sasisopin; Kumarasamy, Nagalingeswaran; Vonthanak, Saphonn; Lee, Christopher K.C.; Van Kinh, Nguyen; Pujari, Sanjay; Wong, Wing Wai; Kamarulzaman, Adeeba; Zhang, Fujie; Yunihastuti, Evy; Choi, Jun Yong; Oka, Shinichi; Ng, Oon Tek; Kantipong, Pacharee; Mustafa, Mahiran; Ratanasuwan, Winai; Durier, Nicolas; Law, Matthew.

In: Antiviral therapy, Vol. 21, No. 1, 01.01.2016, p. 27-35.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Tenofovir-based antiretroviral therapy in HBV-HIV coinfection

T2 - Results from the treat Asia HIV Observational Database

AU - Boettiger, David C.

AU - Kerr, Stephen

AU - Ditangco, Rossana

AU - Chaiwarith, Romanee

AU - Li, Patrick C.K.

AU - Merati, Tuti Parwati

AU - Pham, Thuy Thi Thanh

AU - Kiertiburanakul, Sasisopin

AU - Kumarasamy, Nagalingeswaran

AU - Vonthanak, Saphonn

AU - Lee, Christopher K.C.

AU - Van Kinh, Nguyen

AU - Pujari, Sanjay

AU - Wong, Wing Wai

AU - Kamarulzaman, Adeeba

AU - Zhang, Fujie

AU - Yunihastuti, Evy

AU - Choi, Jun Yong

AU - Oka, Shinichi

AU - Ng, Oon Tek

AU - Kantipong, Pacharee

AU - Mustafa, Mahiran

AU - Ratanasuwan, Winai

AU - Durier, Nicolas

AU - Law, Matthew

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: The World Health Organization recommends HBV-HIV-coinfected individuals start antiretroviral therapy containing tenofovir. Here we describe irst-line tenofovir use and treatment outcomes in coinfected patients in Asia. Methods: HBV surface antigen positive patients enrolled in the TREAT Asia HIV Observational Database who started irst-line antiretroviral therapy were included. Logistic regression adjusted for period of treatment initiation was used to determine factors associated with tenofovir use. Generalized estimating equations were used to evaluate factors associated with alanine transaminase levels and CD4+ T-cell count on treatment. Results: There were 548 eligible patients, of whom 149 (27.2%) started tenofovir. Patients treated in high/highmiddle income countries (odds ratio 4.4 versus low/lowmiddle, 95% CI 2.6, 7.4; P<0.001) and those with elevated baseline alanine transaminase (odds ratio 4.2 versus normal, 95% CI 2.4, 7.2; P<0.001) were more likely to receive tenofovir. Hepatitis C antibody positive patients (odds ratio 0.4 versus negative, 95% CI 0.2, 0.8; P=0.008) were less likely. In those starting antiretroviral therapy with elevated alanine transaminase, mean reduction after tenofovir initiation was 11.2 IU/l (95% CI 0.9, 21.6; P=0.034) lower compared with those using a non-tenofovir-based regimen although this did not signiicantly increase the chance of alanine transaminase normalization. Tenofovir use was not associated with a superior CD4+ T-cell response. Conclusions: HBV-HIV-coinfected patients in Asia are most likely to receive tenofovir if they are treated in a high/highmiddle income country, have elevated alanine transaminase levels and are hepatitis C antibody negative. Compared to other antiretroviral therapies, tenofovir-based regimens more effectively reduce liver inlammation in HBV-HIV-coinfection but do not result in superior CD4+ T-cell recovery.

AB - Background: The World Health Organization recommends HBV-HIV-coinfected individuals start antiretroviral therapy containing tenofovir. Here we describe irst-line tenofovir use and treatment outcomes in coinfected patients in Asia. Methods: HBV surface antigen positive patients enrolled in the TREAT Asia HIV Observational Database who started irst-line antiretroviral therapy were included. Logistic regression adjusted for period of treatment initiation was used to determine factors associated with tenofovir use. Generalized estimating equations were used to evaluate factors associated with alanine transaminase levels and CD4+ T-cell count on treatment. Results: There were 548 eligible patients, of whom 149 (27.2%) started tenofovir. Patients treated in high/highmiddle income countries (odds ratio 4.4 versus low/lowmiddle, 95% CI 2.6, 7.4; P<0.001) and those with elevated baseline alanine transaminase (odds ratio 4.2 versus normal, 95% CI 2.4, 7.2; P<0.001) were more likely to receive tenofovir. Hepatitis C antibody positive patients (odds ratio 0.4 versus negative, 95% CI 0.2, 0.8; P=0.008) were less likely. In those starting antiretroviral therapy with elevated alanine transaminase, mean reduction after tenofovir initiation was 11.2 IU/l (95% CI 0.9, 21.6; P=0.034) lower compared with those using a non-tenofovir-based regimen although this did not signiicantly increase the chance of alanine transaminase normalization. Tenofovir use was not associated with a superior CD4+ T-cell response. Conclusions: HBV-HIV-coinfected patients in Asia are most likely to receive tenofovir if they are treated in a high/highmiddle income country, have elevated alanine transaminase levels and are hepatitis C antibody negative. Compared to other antiretroviral therapies, tenofovir-based regimens more effectively reduce liver inlammation in HBV-HIV-coinfection but do not result in superior CD4+ T-cell recovery.

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