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Hepatitis B incidence and prevention with antiretroviral therapy among HIV-positive individuals in Uganda

Antiretroviral therapy (ART) may interfere with replication of hepatitis B virus (HBV), raising the hypothesis that HBV infection might be prevented by ART. We investigated the incidence and risk factors associated with HBV among HIV-infected adults in Rakai, Uganda. We screened stored sera from 944... Full description

Journal Title: AIDS (London) 2017-03-27, Vol.31 (6), p.781-786
Main Author: Seremba, Emmanuel
Other Authors: Ssempijja, Victor , Kalibbala, Sarah , Gray, Ronald H , Wawer, Maria J , Nalugoda, Fred , Casper, Corey , Phipps, Warren , Ocama, Ponsiano , Serwadda, David , Thomas, David L , Reynolds, Steven J
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: England
ID: ISSN: 0269-9370
Link: https://www.ncbi.nlm.nih.gov/pubmed/28099188
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title: Hepatitis B incidence and prevention with antiretroviral therapy among HIV-positive individuals in Uganda
format: Article
creator:
  • Seremba, Emmanuel
  • Ssempijja, Victor
  • Kalibbala, Sarah
  • Gray, Ronald H
  • Wawer, Maria J
  • Nalugoda, Fred
  • Casper, Corey
  • Phipps, Warren
  • Ocama, Ponsiano
  • Serwadda, David
  • Thomas, David L
  • Reynolds, Steven J
subjects:
  • AIDS/HIV
  • Anti-Retroviral Agents - therapeutic use
  • Chemoprevention - methods
  • Cohort Studies
  • Hepatitis B - epidemiology
  • Hepatitis B - prevention & control
  • Hepatitis B Antibodies - blood
  • Hepatitis B virus
  • HIV Infections - complications
  • HIV Infections - drug therapy
  • Incidence
  • Lentivirus
  • Retroviridae
  • Risk Factors
  • Uganda - epidemiology
ispartof: AIDS (London), 2017-03-27, Vol.31 (6), p.781-786
description: Antiretroviral therapy (ART) may interfere with replication of hepatitis B virus (HBV), raising the hypothesis that HBV infection might be prevented by ART. We investigated the incidence and risk factors associated with HBV among HIV-infected adults in Rakai, Uganda. We screened stored sera from 944 HIV-infected adults enrolled in the Rakai Community Cohort Study between September 2003 and March 2015 for evidence of HBV exposure. Serum from participants who tested anti-hepatitis B core-negative (497) at baseline were tested over 3-7 consecutive survey rounds for incident HBV. Poisson incidence methods were used to estimate incidence of HBV with 95% confidence intervals (CIs), whereas Cox proportional regression methods were used to estimate hazard ratios (HRs). Thirty-nine HBV infections occurred over 3342 person-years, incidence 1.17/100 person-years. HBV incidence was significantly lower with ART use: 0.49/100 person-years with ART and 2.3/100 person-years without ART [adjusted HR (aHR) 0.25, 95% CI 0.1-0.5, P 
language: eng
source:
identifier: ISSN: 0269-9370
fulltext: no_fulltext
issn:
  • 0269-9370
  • 1473-5571
url: Link


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titleHepatitis B incidence and prevention with antiretroviral therapy among HIV-positive individuals in Uganda
creatorSeremba, Emmanuel ; Ssempijja, Victor ; Kalibbala, Sarah ; Gray, Ronald H ; Wawer, Maria J ; Nalugoda, Fred ; Casper, Corey ; Phipps, Warren ; Ocama, Ponsiano ; Serwadda, David ; Thomas, David L ; Reynolds, Steven J
creatorcontribSeremba, Emmanuel ; Ssempijja, Victor ; Kalibbala, Sarah ; Gray, Ronald H ; Wawer, Maria J ; Nalugoda, Fred ; Casper, Corey ; Phipps, Warren ; Ocama, Ponsiano ; Serwadda, David ; Thomas, David L ; Reynolds, Steven J
descriptionAntiretroviral therapy (ART) may interfere with replication of hepatitis B virus (HBV), raising the hypothesis that HBV infection might be prevented by ART. We investigated the incidence and risk factors associated with HBV among HIV-infected adults in Rakai, Uganda. We screened stored sera from 944 HIV-infected adults enrolled in the Rakai Community Cohort Study between September 2003 and March 2015 for evidence of HBV exposure. Serum from participants who tested anti-hepatitis B core-negative (497) at baseline were tested over 3-7 consecutive survey rounds for incident HBV. Poisson incidence methods were used to estimate incidence of HBV with 95% confidence intervals (CIs), whereas Cox proportional regression methods were used to estimate hazard ratios (HRs). Thirty-nine HBV infections occurred over 3342 person-years, incidence 1.17/100 person-years. HBV incidence was significantly lower with ART use: 0.49/100 person-years with ART and 2.3/100 person-years without ART [adjusted HR (aHR) 0.25, 95% CI 0.1-0.5, P < 0.001], and with lamivudine (3TC) use: 0.58/100 person-years) with 3TC and 2.25/100 person-years without 3TC (aHR 0.32, 95% CI 0.1-0.7, P =  < 0.007). No new HBV infections occurred among those on tenofovir-based ART. HBV incidence also decreased with HIV RNA suppression: 0.6/100 person-years with 400 copies/ml or less and 4.0/100 person-years with more than 400 copies/ml (aHR, 6.4, 95% CI 2.2-19.0, P < 0.001); and with age: 15-29 years versus 40-50 years (aHR 3.2, 95% CI 1.2-9.0); 30-39 years versus 40-50 years (aHR 2.1, 95% CI 0.9-5.3). HBV continues to be acquired in adulthood among HIV-positive Ugandans and HBV incidence is dramatically reduced with HBV-active ART. In addition to widespread vaccination, initiation of ART may prevent HBV acquisition among HIV-positive adults in sub-Saharan Africa.
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subjectAIDS/HIV ; Anti-Retroviral Agents - therapeutic use ; Chemoprevention - methods ; Cohort Studies ; Hepatitis B - epidemiology ; Hepatitis B - prevention & control ; Hepatitis B Antibodies - blood ; Hepatitis B virus ; HIV Infections - complications ; HIV Infections - drug therapy ; Incidence ; Lentivirus ; Retroviridae ; Risk Factors ; Uganda - epidemiology
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descriptionAntiretroviral therapy (ART) may interfere with replication of hepatitis B virus (HBV), raising the hypothesis that HBV infection might be prevented by ART. We investigated the incidence and risk factors associated with HBV among HIV-infected adults in Rakai, Uganda. We screened stored sera from 944 HIV-infected adults enrolled in the Rakai Community Cohort Study between September 2003 and March 2015 for evidence of HBV exposure. Serum from participants who tested anti-hepatitis B core-negative (497) at baseline were tested over 3-7 consecutive survey rounds for incident HBV. Poisson incidence methods were used to estimate incidence of HBV with 95% confidence intervals (CIs), whereas Cox proportional regression methods were used to estimate hazard ratios (HRs). Thirty-nine HBV infections occurred over 3342 person-years, incidence 1.17/100 person-years. HBV incidence was significantly lower with ART use: 0.49/100 person-years with ART and 2.3/100 person-years without ART [adjusted HR (aHR) 0.25, 95% CI 0.1-0.5, P < 0.001], and with lamivudine (3TC) use: 0.58/100 person-years) with 3TC and 2.25/100 person-years without 3TC (aHR 0.32, 95% CI 0.1-0.7, P =  < 0.007). No new HBV infections occurred among those on tenofovir-based ART. HBV incidence also decreased with HIV RNA suppression: 0.6/100 person-years with 400 copies/ml or less and 4.0/100 person-years with more than 400 copies/ml (aHR, 6.4, 95% CI 2.2-19.0, P < 0.001); and with age: 15-29 years versus 40-50 years (aHR 3.2, 95% CI 1.2-9.0); 30-39 years versus 40-50 years (aHR 2.1, 95% CI 0.9-5.3). HBV continues to be acquired in adulthood among HIV-positive Ugandans and HBV incidence is dramatically reduced with HBV-active ART. In addition to widespread vaccination, initiation of ART may prevent HBV acquisition among HIV-positive adults in sub-Saharan Africa.
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13Risk Factors
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titleHepatitis B incidence and prevention with antiretroviral therapy among HIV-positive individuals in Uganda
authorSeremba, Emmanuel ; Ssempijja, Victor ; Kalibbala, Sarah ; Gray, Ronald H ; Wawer, Maria J ; Nalugoda, Fred ; Casper, Corey ; Phipps, Warren ; Ocama, Ponsiano ; Serwadda, David ; Thomas, David L ; Reynolds, Steven J
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abstractAntiretroviral therapy (ART) may interfere with replication of hepatitis B virus (HBV), raising the hypothesis that HBV infection might be prevented by ART. We investigated the incidence and risk factors associated with HBV among HIV-infected adults in Rakai, Uganda. We screened stored sera from 944 HIV-infected adults enrolled in the Rakai Community Cohort Study between September 2003 and March 2015 for evidence of HBV exposure. Serum from participants who tested anti-hepatitis B core-negative (497) at baseline were tested over 3-7 consecutive survey rounds for incident HBV. Poisson incidence methods were used to estimate incidence of HBV with 95% confidence intervals (CIs), whereas Cox proportional regression methods were used to estimate hazard ratios (HRs). Thirty-nine HBV infections occurred over 3342 person-years, incidence 1.17/100 person-years. HBV incidence was significantly lower with ART use: 0.49/100 person-years with ART and 2.3/100 person-years without ART [adjusted HR (aHR) 0.25, 95% CI 0.1-0.5, P < 0.001], and with lamivudine (3TC) use: 0.58/100 person-years) with 3TC and 2.25/100 person-years without 3TC (aHR 0.32, 95% CI 0.1-0.7, P =  < 0.007). No new HBV infections occurred among those on tenofovir-based ART. HBV incidence also decreased with HIV RNA suppression: 0.6/100 person-years with 400 copies/ml or less and 4.0/100 person-years with more than 400 copies/ml (aHR, 6.4, 95% CI 2.2-19.0, P < 0.001); and with age: 15-29 years versus 40-50 years (aHR 3.2, 95% CI 1.2-9.0); 30-39 years versus 40-50 years (aHR 2.1, 95% CI 0.9-5.3). HBV continues to be acquired in adulthood among HIV-positive Ugandans and HBV incidence is dramatically reduced with HBV-active ART. In addition to widespread vaccination, initiation of ART may prevent HBV acquisition among HIV-positive adults in sub-Saharan Africa.
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doi10.1097/QAD.0000000000001399
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