Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study
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Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study. / Peters, Lars; Mocroft, Amanda; Grint, Daniel; Moreno, Santiago; Calmy, Alexandra; Jevtovic, Djordje; Sambatakou, Helen; Lacombe, Karine; De Wit, Stephane; Rockstroh, Jürgen; Smidt, Jelena; Karpov, Igor; Grzeszczuk, Anna; Haziosmanovic, Vesnadarjan; Gottfredsson, Magnus; Radoi, Roxana; Kuzovatova, Elena; Orkin, Chloe; Ridolfo, Anna Lisa; Zapirain, Jose; Lundgren, Jens.
In: Antiviral Therapy, Vol. 23, No. 5, 2018, p. 405-413.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study
AU - Peters, Lars
AU - Mocroft, Amanda
AU - Grint, Daniel
AU - Moreno, Santiago
AU - Calmy, Alexandra
AU - Jevtovic, Djordje
AU - Sambatakou, Helen
AU - Lacombe, Karine
AU - De Wit, Stephane
AU - Rockstroh, Jürgen
AU - Smidt, Jelena
AU - Karpov, Igor
AU - Grzeszczuk, Anna
AU - Haziosmanovic, Vesnadarjan
AU - Gottfredsson, Magnus
AU - Radoi, Roxana
AU - Kuzovatova, Elena
AU - Orkin, Chloe
AU - Ridolfo, Anna Lisa
AU - Zapirain, Jose
AU - Lundgren, Jens
PY - 2018
Y1 - 2018
N2 - BACKGROUND: According to guidelines all HIV-HBV-coinfected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV-HBV patients in the EuroSIDA study.METHODS: All hepatitis B surface antigen (HBsAg)+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events.RESULTS: 953 HIV-HBV patients were included. Median age was 41 years and patients were predominantly male (85%), White (82%) and ART-experienced (88%). 697 and 256 were from Western and Eastern Europe, respectively. 55 started cART during follow-up, the proportion starting with CD4+ T-cell count <350 cells/mm3 decreased from 85% to 52% in the periods 2002-2006 to 2007-2015. Tenofovir use, among those taking cART, increased from 4% in 2002 to 73% in 2015. Compared to West, tenofovir use was lower in East in 2005 (7% versus 42%), and remained lower in 2015 (63% versus 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. 27 of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas 10 started pegylated interferon. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (n=51), adjusted incidence rate ratio (IRR) 0.64 (95% CI 0.35, 1.18) for comparing patients on tenofovir with those off tenofovir.CONCLUSIONS: Although use of tenofovir-based cART among HIV-HBV patients has increased across Europe, a substantial proportion are still starting cART late and are receiving suboptimal HBV therapy.
AB - BACKGROUND: According to guidelines all HIV-HBV-coinfected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV-HBV patients in the EuroSIDA study.METHODS: All hepatitis B surface antigen (HBsAg)+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events.RESULTS: 953 HIV-HBV patients were included. Median age was 41 years and patients were predominantly male (85%), White (82%) and ART-experienced (88%). 697 and 256 were from Western and Eastern Europe, respectively. 55 started cART during follow-up, the proportion starting with CD4+ T-cell count <350 cells/mm3 decreased from 85% to 52% in the periods 2002-2006 to 2007-2015. Tenofovir use, among those taking cART, increased from 4% in 2002 to 73% in 2015. Compared to West, tenofovir use was lower in East in 2005 (7% versus 42%), and remained lower in 2015 (63% versus 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. 27 of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas 10 started pegylated interferon. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (n=51), adjusted incidence rate ratio (IRR) 0.64 (95% CI 0.35, 1.18) for comparing patients on tenofovir with those off tenofovir.CONCLUSIONS: Although use of tenofovir-based cART among HIV-HBV patients has increased across Europe, a substantial proportion are still starting cART late and are receiving suboptimal HBV therapy.
U2 - 10.3851/IMP3218
DO - 10.3851/IMP3218
M3 - Journal article
C2 - 29303483
VL - 23
SP - 405
EP - 413
JO - Antiviral Therapy
JF - Antiviral Therapy
SN - 1359-6535
IS - 5
ER -
ID: 215465510