Abdullahi, Adam

Beloukas, Apostolos

Fopoussi, Olga Mafotsing

Geretti, Anna M

Kouanfack, Charles

Torimiro, Judith

University of Liverpool Repository

CONTROL ID:  2780554PRESENTATION TYPE:  Oral or PosterCURRENT CATEGORY:  Hepatitis BCURRENT DESCRIPTORS:  HO2. Diagnostics, Epidemiology, Prevention, and Natural HistoryTITLE:  Risk of hepatitis B virus (HBV) infection and re-activation after discontinuation of tenofovir and/or lamivudineas part of antiretroviral therapy in a high HBV endemicity settingAUTHORS (FIRST NAME, LAST NAME): Adam Abdullah1, Apostolos Beloukas1, Olga Mafotsing Fopoussi1, JudithTorimiro2, Charles Kouanfack3, Anna M. Geretti1Oral/Poster: Institutional Author(s):  HEPA Study GroupINSTITUTIONS (ALL):  1. University of Liverpool, Liverpool, Merseyside, United Kingdom. 2. CIRCB, Yaounde, Cameroon. 3. Yaounde Central Hospital, Yaounde, Cameroon.ABSTRACT BODY: Abstract Body:  Background: In HIV-positive patients, including HBV-active agents as part of antiretroviral therapy(ART) is proposed to exert a prophylactic effect against both de novo acquisition of HBV and reactivation of apreviously resolved HBV infection. The aim of this study was to determine the risk of HBV infection and reactivation inHIV-positive patients who discontinued HBV-active agents (tenofovir and/or lamivudine) as part of ART in Yaoundé,Cameroon. Methods: The study recruited 80 patients who tested HBsAg and HBV DNA negative at study entry (baseline) anddiscontinued tenofovir and/or lamivudine while continuing ART with a ritonavir-boosted protease inhibitor. Serumsamples were collected at planned study visits (week 0, 4, 12, 24, 36, 48), stored at -80oC, and tested retrospectivelyfor the following HBV markers: HBsAg, HBsAb, Total HBcAb, HBeAg, HBeAb (Abbott Architect platform), and HBVDNA (Abbott RealTime HBV DNA assay; lower limit of quantification 10 IU/ml). HBsAg positive results were confirmedby neutralisation. Incident HBV infection was defined by detection of HBsAg, HBV DNA, and Total HBcAb in subjectslacking HBsAg, HBV DNA, Total HBcAb and HBeAb at baseline. HBV reactivation was defined by detection of HBsAgand HBV DNA in subjects with Total HBcAb at baseline. Results: Evidence of incident HBV infection was observed in 2/80 (2.5%) subjects at week 12 and week 24 of follow-up, respectively. One subject (all HBV markers negative at baseline) experienced acute hepatitis with markedly raisedtransaminases (ALT/AST 824/661 U/L) and jaundice at week 12. The second subject (baseline HBsAb 17 IU/L; allother HBV markers negative at baseline) experienced an asymptomatic infection coinciding with a modest raise intransaminases (ALT/AST 27/27 IU/L at baseline and 59/42 IU/L at week 24). HBV reactivation occurred in 2/80 (2.5%)subjects (baseline HBsAb 191 IU/L and 169 IU/L, respectively). Both incident and reactivated infections resolvedfollowing the addition of tenofovir and lamivudine to the ART regimen. CD4 cell counts in the 4 patients were median438 cells/mm3 (range 317-734); all subjects had suppressed plasma HIV-1 RNA load (<60 copies/ml). Conclusion: HIV-positive patients who discontinue HBV-active agents as part of ART in a setting of high HBVendemicity are at risk of both de novo HBV acquisition and reactivation of a previously resolved HBV infection. Theobservation does not appear to correlate with poor HIV control and significant immune suppression. HBV reactivationin the presence of HBsAb levels >100 U/L suggests possible escape from antibody neutralisation. (no table selected)(No Image Selected)Co-Author Disclosure Status  The following authors have completed their AASLD 2017 disclosure: Adam Abdullah: No Answer. | ApostolosBeloukas: No Answer. | Olga Mafotsing Fopoussi: No Answer. | Judith Torimiro: No Answer. | Charles Kouanfack: NoAnswer. | Anna Geretti: Disclosure completed

Risk of hepatitis B virus (HBV) infection and re-activation after discontinuation of tenofovir and/or lamivudine as part of antiretroviral therapy in a high HBV endemicity setting

http://livrepository.liverpool.ac.uk/3011429/1/AASLD_Abstract_2017.pdf

Risk of hepatitis B virus (HBV) infection and re-activation after discontinuation of tenofovir and/or lamivudine as part of antiretroviral therapy in a high HBV endemicity setting

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