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Impact of hepatitis D virus infection on the long-term outcomes of patients with hepatitis B virus and HIV coinfection in the era of highly active antiretroviral therapy: a matched cohort study.
Clin Infect Dis. 2007 Apr 01; 44(7):988-95.CI

Abstract

BACKGROUND

Triple infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis D virus (HDV) is rare. The influence of HDV infection on the responses to highly active antiretroviral therapy and hepatic complications in patients with HBV-HIV coinfection remains uncertain.

METHODS

Twenty-six HDV-infected case patients and 78 HDV-uninfected matched control subjects were identified between 1 January 1995 and 30 June 2003. Clinical and immunologic outcomes were noted, and HBV and HIV loads and genotypic resistance of HBV to lamivudine were determined.

RESULTS

Case patients had a higher rate of injection drug use (7.7% vs. 1.3%; P=.05) and lower serum levels of HBV DNA (median level, 4.04 vs. 5.75 log10 copies/mL; P=.07) than control subjects. During a median observation period of 54.7 months, HDV infection did not have an adverse impact on clinical, virological, or immunologic responses to highly active antiretroviral therapy. However, case patients had higher rates of hepatitis flares (57.7% vs. 23.1%; P=.002), hyperbilirubinemia (34.6% vs. 14.1%; P=.04), liver cirrhosis (26.9% vs. 5.1%; P=.009), hepatic decompensation (23.1% vs. 5.1%; P=.007), and death (adjusted hazard ratio, 5.41; 95% confidence interval, 1.39-23.85; P=.02), although these patients had a lower risk of genotypic resistance to lamivudine (0% vs. 57.1%; P=.003).

CONCLUSIONS

HDV infection did not affect clinical, virological, or immunologic responses to highly active antiretroviral therapy in patients with HBV-HIV coinfection. HDV infection increased risk of hepatitis flares, liver cirrhosis, hepatic decompensation, and death in patients with HBV-HIV coinfection.

Authors+Show Affiliations

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17342655

Citation

Sheng, Wang-Huei, et al. "Impact of Hepatitis D Virus Infection On the Long-term Outcomes of Patients With Hepatitis B Virus and HIV Coinfection in the Era of Highly Active Antiretroviral Therapy: a Matched Cohort Study." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 44, no. 7, 2007, pp. 988-95.
Sheng WH, Hung CC, Kao JH, et al. Impact of hepatitis D virus infection on the long-term outcomes of patients with hepatitis B virus and HIV coinfection in the era of highly active antiretroviral therapy: a matched cohort study. Clin Infect Dis. 2007;44(7):988-95.
Sheng, W. H., Hung, C. C., Kao, J. H., Chang, S. Y., Chen, M. Y., Hsieh, S. M., Chen, P. J., & Chang, S. C. (2007). Impact of hepatitis D virus infection on the long-term outcomes of patients with hepatitis B virus and HIV coinfection in the era of highly active antiretroviral therapy: a matched cohort study. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 44(7), 988-95.
Sheng WH, et al. Impact of Hepatitis D Virus Infection On the Long-term Outcomes of Patients With Hepatitis B Virus and HIV Coinfection in the Era of Highly Active Antiretroviral Therapy: a Matched Cohort Study. Clin Infect Dis. 2007 Apr 1;44(7):988-95. PubMed PMID: 17342655.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of hepatitis D virus infection on the long-term outcomes of patients with hepatitis B virus and HIV coinfection in the era of highly active antiretroviral therapy: a matched cohort study. AU - Sheng,Wang-Huei, AU - Hung,Chien-Ching, AU - Kao,Jia-Horng, AU - Chang,Sui-Yuan, AU - Chen,Mao-Yuan, AU - Hsieh,Szu-Min, AU - Chen,Pei-Jer, AU - Chang,Shan-Chwen, Y1 - 2007/02/20/ PY - 2006/09/05/received PY - 2006/12/05/accepted PY - 2007/3/8/pubmed PY - 2007/3/30/medline PY - 2007/3/8/entrez SP - 988 EP - 95 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 44 IS - 7 N2 - BACKGROUND: Triple infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis D virus (HDV) is rare. The influence of HDV infection on the responses to highly active antiretroviral therapy and hepatic complications in patients with HBV-HIV coinfection remains uncertain. METHODS: Twenty-six HDV-infected case patients and 78 HDV-uninfected matched control subjects were identified between 1 January 1995 and 30 June 2003. Clinical and immunologic outcomes were noted, and HBV and HIV loads and genotypic resistance of HBV to lamivudine were determined. RESULTS: Case patients had a higher rate of injection drug use (7.7% vs. 1.3%; P=.05) and lower serum levels of HBV DNA (median level, 4.04 vs. 5.75 log10 copies/mL; P=.07) than control subjects. During a median observation period of 54.7 months, HDV infection did not have an adverse impact on clinical, virological, or immunologic responses to highly active antiretroviral therapy. However, case patients had higher rates of hepatitis flares (57.7% vs. 23.1%; P=.002), hyperbilirubinemia (34.6% vs. 14.1%; P=.04), liver cirrhosis (26.9% vs. 5.1%; P=.009), hepatic decompensation (23.1% vs. 5.1%; P=.007), and death (adjusted hazard ratio, 5.41; 95% confidence interval, 1.39-23.85; P=.02), although these patients had a lower risk of genotypic resistance to lamivudine (0% vs. 57.1%; P=.003). CONCLUSIONS: HDV infection did not affect clinical, virological, or immunologic responses to highly active antiretroviral therapy in patients with HBV-HIV coinfection. HDV infection increased risk of hepatitis flares, liver cirrhosis, hepatic decompensation, and death in patients with HBV-HIV coinfection. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/17342655/Impact_of_hepatitis_D_virus_infection_on_the_long_term_outcomes_of_patients_with_hepatitis_B_virus_and_HIV_coinfection_in_the_era_of_highly_active_antiretroviral_therapy:_a_matched_cohort_study_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/511867 DB - PRIME DP - Unbound Medicine ER -