Epidemiological Study Of Impact Of HIV/HBV Co-infection On Disease Progression Of AIDS And Hepatitis B

Part 1 HBV coinfection among newly diagnosed HIV-infected adults in Taizhou city of Zhejiang Province, China.ObjectiveTo determine the prevalence of hepatitis B virus (HBV) and correlates of Hepatitis B viremia levels among adults newly diagnosed with HIV in Taizhou city of Zhejiang Province, China.MethodsFive hundred and seventy-two adults newly diagnosed with HIV in Taizhou were selected during 2009 to 2012. HBV infection was screened by HBsAg. HBV DNA was also detected and quantified if HBsAg was positive.ResultsOverall,91 participants were tested HBsAg positive and the prevalence of HBV co-infection was 15.9%. Participants between 40-49 years old were shown to have a higher HBV co-infection rate than those more than 50(OR=3.01,95%CI:1.24-7.29); People of minority had a higher HBV co-infection rate than Han(OR=2.61, 95%CI: 1.04-6.52); Participants acquired HTV via other route of transmission had a lower HBV co-infection rate than those who infected HTV through homosexual(OR=0.18, 95%CI:0.04-0.90).26 out of 91(28.6%) HIV/HBV co-infection participants had undetectable serum HBV DNA loads(lower than the limit of detection 5.0 X 102IU/ml). We could detect no significant associations between HBV DNA relative suppression rate and the demographics, HIV transmission route and CD4 T-cell counts according to multivariate logistic regression analyses.ConclusionsThe coinfection of HBV was prevalent among newly diagnosed HIV-infected adults in Taizhou city, Zhejiang province. Furthermore, only a minority of them were in the HBV DNA relative suppression state. We could not detect significant associations between HBV DNA relative suppression rate and the characteristics of HIV patients.Part 2 Epidemiological Study of Impact of HIV/HBV Co-infection on Disease Progression of AIDS and Hepatitis BObjectiveTo evaluate the impact of HIV/HBV co-infection on disease progression of AIDS and Hepatitis B and to explore weather or not HIV/HBV coinfection will lead to changes in the level of CD4+T lymphocytes cells counts and HBV-DNA.MethodsThe retrospective investigation of the 572 participants (including 481 HIV mono infected patients and 91 HIV/HBV co-infected patiens) enrolled in the baseline survey was conducted. The influence of HBV coinfection on the disease progression of AIDS was estimated with Kaplan-Meier method and Logistic regression model. The changes of the level of HBV-DNA in the HIV/HBV co-infected patients were estimated with Wilcoxon signed rank test.ResultsThe average duration of follow-up of 572 subjects was 11.5 months by the end of June 30,2013. We could detect no significant diference on the couve of receiving antiviral treatment beteewn HIV mono-infected patients and HIV/HBV co-infected patients. Multiple Logistic regression analysis indicated that the baseline CD4+ T cell counts was significantly associated with a significant depletion of CD4+ T cell counts among the HIV patients. We could detect no significant association between the coinfection of HBV and a significant depletion of CD4+T cell counts.The last level of HBV viral load was lower than the baseline level of HBV viral load among the 42 HIV/HBV co-infeted patients. We could detect no significant association between the HBV viral load and CD4+T cell counts both at the baseline and the last time.ConclusionsThe co-infction of HBV had no significant influence to the decrease of CD4+ T cell counts in the HIV/AIDS patients. The baseline CD4+ T cell counts was significantly associated with a significant depletion of CD4+ T cell counts among the HIV patients.The level of HBV-DNA viral load decreased over time. We could detect no significant association between the HBV-DNA viral load and CD4+ T cell counts.Part 3 Immunological and virological response to cART in HIV/HBV co-infected petiensObjectiveTo evaluate the influence of HBV co-infection on immunological and virological responses to lamivudine-based combined antiretroviral therapy (cART) in HIV/HBV co-infection patients in Taizhou city, Zhejiang province.MethodsThe retrospective cohort study of the HIV-infected patients enrolled in the baseline survey was conducted. All of the participants had received highly active antiretroviral therapy. They were divided into HIV mono infected patients and HIV/HBV co-infected patiens by HBV serostatus.Virological and immunological responses were monitored at baseline and month 3,6,12 and 24.cART for all patients was 3TC with NVP, EFV, D4T or AZT.ResultsOverall,293 patients (243 non-coinfected and 50 coinfected) were evaluated. Coinfected patients had higher baseline alanine aminotransferase levels.CD4+T cell count reaponse was similar in the two groups. HBV coinfection did not influence the immunological response to cART at each follow-up time point. Hepatotoxicity was significantly higher in coinfected patients at month 3(HIV 17.8% and HIV/HBV 39.5%).However, hepatotoxicity was similar after treatment of 6 months.3TC-based cART was efficacious against HBV replication. The HBV viral load was decreasing while the HBV DNA relative suppression rate was rising compared with the baseline.ConclusionsImmunological reaponse to 3TC-based cART is not negatively affected by coinfection with HBV. The early hepatotoxicity is more common in HIV/HBV coinfected patients.3TC-based cART could inhibit the replication of HBV.