In patients with both HIV and hepatitis B, prolonged use of drugs active against both viruses improves the odds of clearing the hepatitis, researchers said.
Action Points
* Explain to interested patients that patients with both HIV and hepatitis B are at higher risk of liver complications.
* Note that this study found that longer use of antiretrovirals that are also active against hepatitis B increased the odds of clearing the infection.
In a retrospective, longitudinal study, patients who were on such highly active antiretroviral therapy (HAART) for a longer period had nearly three times the likelihood of clearing the HBeAg antigen associated with active hepatitis B, according to Marina Núñez, MD, PhD, and a colleague at Wake Forest University School of Medicine in Winston-Salem, N.C.
Those patients also had a 54% improvement in the chance of clearing the so-called surface antigen — HBsAg — the researchers said in the May/June issue of HIV Clinical Trials.
In addition, the researchers found that patients with higher levels of alanine aminotransferase at baseline were at a higher risk of being diagnosed with cirrhosis within a few years.
“One of the most interesting findings was the confirmation that a simple marker, such as transaminase levels before treatment, is useful in identifyingpatients at higher risk of developing (hepatitis B-related) complications in a few years,” Dr. Núñez said in a statement.
The researchers looked at medical records of 72 patients treated at Wake Forest University Baptist Medical Center between 1990 and 2008 who had both HIV and hepatitis B.
During follow-up, 64 (or 88.9%) of the patients had HAART containing drugs active against hepatitis B, including tenofovir (Viread), lamivudine (3TC), or emtricitabine (Emtriva).
Most patients took at least two active drugs during follow-up, but 11.1% took only one antiretroviral with hepatitis B activity.
Six out of 34 patients positive for HBeAg (or 17.6%) cleared the antigen, the researchers found. The only factor that was associated with HBeAg clearance was long use of the medications.