Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study

Lars Peters; Amanda Mocroft; Daniel Grint; Santiago Moreno; Alexandra Calmy; Djordje Jevtovic; Helen Sambatakou; Karine Lacombe; Stephane De Wit; Jürgen Rockstroh; Jelena Smidt; Igor Karpov; Anna Grzeszczuk; Vesnadarjan Haziosmanovic; Magnus Gottfredsson; Roxana Radoi; Elena Kuzovatova; Chloe Orkin; Anna Lisa Ridolfo; Jose Zapirain; Jens Lundgren

doi:10.3851/IMP3218

Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study

Lars Peters, Amanda Mocroft, Daniel Grint, Santiago Moreno, Alexandra Calmy, Djordje Jevtovic, Helen Sambatakou, Karine Lacombe, Stephane De Wit, Jürgen Rockstroh, Jelena Smidt, Igor Karpov, Anna Grzeszczuk, Vesnadarjan Haziosmanovic, Magnus Gottfredsson, Roxana Radoi, Elena Kuzovatova, Chloe Orkin, Anna Lisa Ridolfo, Jose ZapirainJens Lundgren

4 Citationer (Scopus)

Abstract

BACKGROUND: According to guidelines all HIV/HBV co-infected 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 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. Fifty-five started cART during follow-up, the proportion starting with CD4<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% vs. 42%), and remained lower in 2015 (63% vs. 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. Twenty-seven of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas ten started PEG-IFN. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (N=51), adjusted 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.

Originalsprog	Engelsk
Tidsskrift	Antiviral Therapy
Sider (fra-til)	405-413
ISSN	1359-6535
DOI	https://doi.org/10.3851/IMP3218
Status	Udgivet - 2018

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10.3851/IMP3218

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Peters, L., Mocroft, A., Grint, D., Moreno, S., Calmy, A., Jevtovic, D., Sambatakou, H., Lacombe, K., De Wit, S., Rockstroh, J., Smidt, J., Karpov, I., Grzeszczuk, A., Haziosmanovic, V., Gottfredsson, M., Radoi, R., Kuzovatova, E., Orkin, C., Ridolfo, A. L., ... Lundgren, J. (2018). Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study. Antiviral Therapy, 405-413. https://doi.org/10.3851/IMP3218

Peters, L, Mocroft, A, Grint, D, Moreno, S, Calmy, A, Jevtovic, D, Sambatakou, H, Lacombe, K, De Wit, S, Rockstroh, J, Smidt, J, Karpov, I, Grzeszczuk, A, Haziosmanovic, V, Gottfredsson, M, Radoi, R, Kuzovatova, E, Orkin, C, Ridolfo, AL, Zapirain, J & Lundgren, J 2018, 'Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study', Antiviral Therapy, s. 405-413. https://doi.org/10.3851/IMP3218

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title = "Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study",

abstract = "BACKGROUND: According to guidelines all HIV/HBV co-infected 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 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. Fifty-five started cART during follow-up, the proportion starting with CD4<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% vs. 42%), and remained lower in 2015 (63% vs. 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. Twenty-seven of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas ten started PEG-IFN. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (N=51), adjusted 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.",

keywords = "Journal Article",

author = "Lars Peters and Amanda Mocroft and Daniel Grint and Santiago Moreno and Alexandra Calmy and Djordje Jevtovic and Helen Sambatakou and Karine Lacombe and {De Wit}, Stephane and J{\"u}rgen Rockstroh and Jelena Smidt and Igor Karpov and Anna Grzeszczuk and Vesnadarjan Haziosmanovic and Magnus Gottfredsson and Roxana Radoi and Elena Kuzovatova and Chloe Orkin and Ridolfo, {Anna Lisa} and Jose Zapirain and Jens Lundgren",

year = "2018",

doi = "10.3851/IMP3218",

language = "English",

pages = "405--413",

journal = "Antiviral Therapy",

issn = "1359-6535",

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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 co-infected 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 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. Fifty-five started cART during follow-up, the proportion starting with CD4<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% vs. 42%), and remained lower in 2015 (63% vs. 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. Twenty-seven of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas ten started PEG-IFN. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (N=51), adjusted 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 co-infected 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 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. Fifty-five started cART during follow-up, the proportion starting with CD4<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% vs. 42%), and remained lower in 2015 (63% vs. 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. Twenty-seven of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas ten started PEG-IFN. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (N=51), adjusted 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.

KW - Journal Article

U2 - 10.3851/IMP3218

DO - 10.3851/IMP3218

M3 - Journal article

C2 - 29303483

SN - 1359-6535

SP - 405

EP - 413

JO - Antiviral Therapy

JF - Antiviral Therapy

ER -

Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study

Abstract

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