KNUSTSpace >
Research Articles >
College of Health Sciences >

Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/13385

Title: Liver Fibrosis by Transient Elastography and Virologic Outcomes After Introduction of Tenofovir in Lamivudine-Experienced Adults With HIV and Hepatitis B Virus Coinfection in Ghana
Authors: Stockdale, Alexander J.
Phillips, Richard Odame
Beloukas, Apostolos
Appiah, Lambert Tetteh
Chadwick, David
Bhagani, Sanjay
Bonnett, Laura
Sarfo, Fred Stephen
Dusheiko, Geoffrey...et.al
Keywords: Hepatitis B
Transient elastography
Issue Date: 15-Sep-2015
Publisher: CID
Citation: CID 2015:61 (15 September)
Abstract: Background. Antiretroviral treatment (ART) programs in sub-Saharan Africa have for many years included lamivudine as the sole hepatitis B virus (HBV) inhibitor. Long-term outcomes and the effects of introducing tenofovir as part of ART in these populations have not been characterized. Methods. The study comprised a cross-sectional analysis of 106 human immunodeficiency virus (HIV)/HBV– coinfected subjects maintained on lamivudine, as well as a prospective analysis of 76 lamivudine-experienced subjects who introduced tenofovir. Patients underwent assessment of liver fibrosis by transient elastography (TE) and testing to characterize HIV type 1 (HIV-1) and HBV replication. Results. After a median of 45 months of lamivudine treatment, HIV-1 RNA and HBV DNA were detectable in 35 of 106 (33.0%) and 54 of 106 (50.9%) subjects, respectively, with corresponding drug resistance rates of 17 of 106 (16.0%) and 31 of 106 (29.2%), respectively. Median TE values were 5.7 kPa (interquartile range, 4.7–7.2 kPa) and independently associated with HBV DNA load, aspartate aminotransferase levels, and platelet counts; 13 of 106 (12.3%) subjects had TE measurements >9.4 kPa. Twelve months after the first assessment, and a median of 7.8 months after introducing tenofovir, HBV DNA levels declined by a mean of 1.5 log10 IU/mL (P < .001). TE values changed by a mean of −0.2 kPa (P = .097), and declined significantly in subjects who had pretenofovir HBV DNA levels >2000 IU/mL (mean, −0.8 kPa; P = .048) or TE values >7.6 kPa (mean, −1.2 kPa; P = .021). HIV-1 RNA detection rates remained unchanged. Conclusions. A proportion of HIV/HBV-coinfected patients on long-term lamivudine-containing ART had poor HIV and HBV suppression, drug resistance, and TE values indicative of advanced liver fibrosis. Tenofovir improved HBV control and reduced liver stiffness in subjects with high HBV DNA load and TE values.
Description: An article published in CID 2015:61 (15 September)
URI: http://hdl.handle.net/123456789/13385
Appears in Collections:College of Health Sciences

Files in This Item:

File Description SizeFormat
civ421.pdf307.4 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.


Valid XHTML 1.0! DSpace Software Copyright © 2002-2010  Duraspace - Feedback