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Wiley InterScience

HIV Medicine

Volume 9 Issue 5, Pages 300 - 306

Published Online: 7 Apr 2008

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ORIGINAL RESEARCH

Impact of hepatitis B virus co-infection on response to highly active antiretroviral treatment and outcome in HIV-infected individuals: a nationwide cohort study

LH Omland ¹ , N Weis ² , P Skinhøj ¹ , AL Laursen ³ , PB Christensen ⁴ , HI Nielsen ⁵ , A Møller ⁶ , F Engsig ¹ , HT Sørensen ^7,8 and N Obel ¹

¹ Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark, ² Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark, ³ Department of Infectious Diseases, Aarhus University Hospital, Denmark, ⁴ Department of Infectious Diseases, Odense University Hospital, Denmark, ⁵ Department of Infectious Diseases, Aalborg Hospital, Denmark, ⁶ Department of Infectious Diseases, Kolding Hospital, Denmark, ⁷ Department of Clinical Epidemiology, Aarhus University Hospital, Denmark and ⁸ Department of Epidemiology, Boston University, MA, USA

Correspondence: Lars H Omland, Department of Infectious Diseases, Rigshospitalet, Blegdamsvej 9, DK2100 Copenhagen Ø, Denmark. Tel: 45 3545 5121; fax: 45 3545 6648; e-mail: omland@dadlnet.dk

KEYWORDS

HBV • HIV • HIV–HBV co-infection

ABSTRACT

Background

The impact of chronic hepatitis B virus (HBV) infection on viral suppression, immune recovery and mortality in HIV-1 infected patients on highly active antiretroviral treatment (HAART) is a matter of debate. The impact of HBeAg status is unknown.

Methods

This prospective cohort study included all adult Danish HIV-1 infected patients who started HAART between 1 January 1995 and 1 December 2006 (3180 patients). Patients were classified as chronic HBV-infected (6%), HBV-negative (87%) or HBV-unknown (7%). HBV-positive patients were divided into HBeAg-positive or -negative (3.0 vs. 2.6%). Study endpoints were viral load, CD4 cell count and mortality.

Results

HBV co-infection had no impact on response to HAART regarding viral suppression or immune recovery. HBV co-infection was associated with several outcomes: overall mortality [mortality rate ratio (MRR) 1.5; 95% confidence interval (CI) 1.1–2.1], liver-related mortality (MRR 4.0; 95% CI 1.6–9.9) and AIDS-related deaths (MRR 1.7; 95% CI 1.0–3.0). The presence of HBeAg did not influence patients' response to HAART.

Conclusions

In HIV patients, chronic HBV infection has no impact on response to HAART concerning viral load and increase in CD4 cell count. However, co-infected patients have an increased mortality compared to HIV-monoinfected patients.

Received: 8 December 2007, accepted 1 February 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1468-1293.2008.00564.x About DOI