TY - JOUR
TI - Uptake of tenofovir-based antiretroviral therapy among
HIV-HBV-coinfected patients in the EuroSIDA study
AU - Peters, Lars
AU - Mocroft, Amanda
AU - Grint, Daniel
AU - Moreno, Santiago
AU - and Calmy, Alexandra
AU - Jevtovic, Djordje
AU - Sambatakou, Helen and
AU - Lacombe, Karine
AU - De Wit, Stephane
AU - Rockstroh, Juergen
AU - Smidt,
AU - Jelena
AU - Karpov, Igor
AU - Grzeszczuk, Anna
AU - Haziosmanovic,
AU - Vesnadarjan
AU - Gottfredsson, Magnus
AU - Radoi, Roxana
AU - Kuzovatova,
AU - Elena
AU - Orkin, Chloe
AU - Ridolfo, Anna Lisa
AU - Zapirain, Jose and
AU - Lundgren, Jens
JO - Antiviral Therapy
PY - 2018
VL - 23
TODO - 5
SP - 405-413
PB - International Medical Press Ltd
SN - 1359-6535
TODO - 10.3851/IMP3218
TODO - null
TODO - 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/mm(3) 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.
ER -