CD4+ T Cell Recovery and Hepatitis B Virus Coinfection in HIV-Infected Patients from Cote d'Ivoire Initiating Antiretroviral Therapy
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AIDS Research and Human Retroviruses. 2018-05, vol. 34, n° 5, p. 439-445
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Immunorecovery could be attenuated in HIV-hepatitis B virus (HBV) co-infection versus HIV mono-infection during antiretroviral therapy (ART), yet whether it also occurs in individuals from Sub-Saharan Africa without severe ...Leer más >
Immunorecovery could be attenuated in HIV-hepatitis B virus (HBV) co-infection versus HIV mono-infection during antiretroviral therapy (ART), yet whether it also occurs in individuals from Sub-Saharan Africa without severe co-morbidities is unknown. In this study, 808 HIV-infected patients in Cote d'Ivoire initiating continuous ART were included. Six-month CD4+ count trajectories and the proportion reaching CD4+ T-cell counts >350/mm3, HIV-RNA <300 copies/mL, still alive and not lost to follow-up within 18 months ("optimal immunorecovery") were compared between co-infected groups. At inclusion, 80 (9.9%) patients were HIV-HBV co-infected, 40 (50.0%) of whom had high HBV-DNA viral load (>104 copies/mL). Co-infected patients with high HBV-DNA replication initiated ART with significantly lower median CD4+ T-cell counts (216/mm3, IQR=150-286) compared to co-infection with low HBV-DNA replication (268/mm3, IQR=178-375) or HIV mono-infection (257/mm3, IQR=194-329) (p=0.003). These patients had significantly faster rates of CD4+ cell count increase from baseline after adjusting for baseline age, WHO stage III/IV and CD4+ cell counts (p=0.04), yet were not more likely to exhibit optimal immunorecovery (82.5% versus 80.0% and 77.9%, respectively) (p=0.8). In conclusion, change in CD4+ cell counts after ART-initiation was accelerated in co-infected patients with high HBV DNA viral loads, but this did not lead to increased rates of optimal immunorecovery.< Leer menos
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