HIV and Hepatitis B Coinfection: Hepatitis B Genotype, Resistance and Outcomes

HIV 和乙型肝炎混合感染：乙型肝炎基因型、耐药性和结果

• 批准号: 8259748
• 负责人: DEBIKA BHATTACHARYA
• 金额: $ 12.34万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-15 至 2013-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8259748
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Affect; Africa; Africa South of the Sahara; African; Anti-Retroviral Agents; Antiviral Agents; Antiviral Therapy; Area; Asia; CD4 Lymphocyte Count; Cessation of life; Characteristics; Cohort Studies; Data; Development; Diagnostic; Fostering; Funding; Future; Genotype; Goals; HBV Genotype; HIV; HIV Infections; Hepatitis B; Hepatitis B Prevalence; Hepatitis B Virus; Hepatitis C; Hepatotoxicity; Individual; Infection; International; Lamivudine; Liver diseases; Master' s Degree; Mentors; Molecular Epidemiology; Mono-S; Outcome; Patients; Pharmaceutical Preparations; Population; Population Study; Populations at Risk; Predictive Factor; Public Health; Publishing; Regimen; Research; Research Personnel; Resistance; Resources; Role; South Africa; Statistical Models; Therapeutic; Training; Treatment outcome; United States National Institutes of Health; Viral Load result; Viral hepatitis; Virus Diseases; antiretroviral therapy; career development; cohort; improved; pandemic disease; patient oriented research; programs; prospective; resistance mutation; response; viral resistance

HIV and hepatitis B (HBV) co-infection is common and significantly increases the progression to liver disease and death. Populations at risk for HIV/HBV co-infection include those in Africa and Asia, regions where HIV continues to spread in the setting of HBV hyperendemicity. Lamivudine (3TC), an antiretroviral (ARV) effective against HBV, is included in 4 WHO first-line ARV regimens, yet there is little data on HIV/HBV treatment outcomes in these areas. Evidence suggests that HBV genotype is predictive of response to therapy. Likewise, HBV and factors such as HBV viral load, genotype, and resistance may contribute to hepatotoxicity during ARV therapy in Africa, and yet little is known about the role of HBV in HIV treatment outcomes. Consistent with the NIAID's goal to foster international collaborative research on HIV,its co- infections, and therapeutic strategies in resource limited settings, the aims of this study are 1) to characterize the prevalence of HBV infection and genotypes in HIV infection 2) to examine the role of HBV genotype in HBV suppression and resistance formation and 3) to examine the association of HBV infection to severe hepatotoxicity in HIV individuals on ARVs in South Africa. A primary aim is to support the applicant's patient- oriented research career development through mentoring, training in molecular epidemiology, and the receipt of a Master's Degree in Public Health. The proposed research is a prospective cohort study nested within the Cape Town AIDS Cohort, an NIH funded study of HIV treatment in South Africa. This population will be characterized for HIV/HBV coinfection and HBV genotype. HBV suppression and resistance will then be determined at 1 year in 135 HIV/HBV coinfected individuals receiving 3TC containing ARV therapy. In an estimated 135 with hepatotoxicity, the presence of HBV infection and virologic factors will be compared to 1215 controls. Potential confounders such as hepatitis C, liver disease, ARV regimen, and other causes of hepatotoxicity will be included in the statistical models of HBV effect on treatment outcomes. The long-term goals of this research are to identify predictors of therapeutic outcomes in HIV/HBV coinfection. This study is the first to examine the role of HBV genotype in HIV/HBV treatment outcomes in a resource limited setting. If HBV virologic factors are associated with treatment outcomes in HIV/HBV coinfection, then identifying such factors may improve future diagnostic and therapeutic strategies in HIV/HBV co-infection.

艾滋病毒和乙型肝炎（HBV）合并感染是常见的，并显著增加肝脏疾病的进展