Hepatitis B serological markers and plasma DNA concentrations.
Hepatitis B serological markers and plasma DNA concentrations.
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DOI：
10.1097/qad.0000000000001454
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发表时间：
2017-05-15
期刊：
影响因子：
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通讯作者：
DART Virology Group
中科院分区：
文献类型：
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作者：
Price H;Dunn D;Zachary T;Vudriko T;Chirara M;Kityo C;Munderi P;Spyer M;Hakim J;Gilks C;Kaleebu P;Pillay D;Gilson R;DART Virology Group
研究撒哈拉以南地区两个地区未经治疗的 HBV/HIV 合并感染者的乙型肝炎 (HBV) 血清学标志物和血浆 DNA 浓度。随机对照试验的基线分析。 DART 是在乌干达坎帕拉或恩德培 (n = 2317) 和津巴布韦哈拉雷 (n = 999) 的中心开始抗逆转录病毒治疗的晚期艾滋病毒感染成人的治疗监测实践的大型试验。对储存的基线样本回顾性测量 HBV 血清学标志物 [HBV 核心抗原抗体、HBV 表面抗原 (HBsAg)、HBV 表面抗原抗体、HBV ‘e’ 抗原 (HBeAg) 和乙型肝炎 ‘e’ 抗原抗体] 和血浆 HBV DNA 病毒载量。使用逻辑回归来检查与基线人口统计和临床因素的关联。津巴布韦的 HBsAg 阳性率显着高于乌干达（12.2 vs. 7.7%，调整后优势比 = 1.54，P < 0.001），尽管两种情况下 HBV 核心抗原抗体的患病率相似（56.3 vs. 52.4%）。总体而言，HBsAg 阳性与男性性别相关（调整后优势比 = 1.54，P < 0.001），但与年龄、WHO 疾病分期或 CD4+ 细胞计数无关。 HBsAg 阳性患者中 HBeAg 检出率为 37%，其中 WHO 分期晚期患者的检出率更高（P = 0.02）。同样，在 HBsAg 阳性患者中，21% 的患者检测不到 HBV DNA，14% 的患者可检测到 HBV DNA，但低于定量水平，65% 的患者可定量。总共 96% 的 HBeAg 阳性患者和 70% 的 HBeAg 阴性患者可检测到 HBV DNA；分别有 92% 和 28% 的患者 HBV DNA 病毒载量超过 2000 IU/ml。观察到乙型肝炎病毒合并感染率很高，这凸显了确保合并感染患者接受对两种病毒均有效的抗逆转录病毒治疗方案的重要性，无论是否是一线治疗。
To examine hepatitis B (HBV) serological markers and plasma DNA concentrations in a large group of untreated HBV/HIV-coinfected individuals in two sub-Saharan settings. Baseline analysis of a randomized controlled trial. DART was a large trial of treatment monitoring practices in HIV-infected adults with advanced disease starting antiretroviral therapy at centres in Kampala or Entebbe, Uganda (n = 2317) and Harare, Zimbabwe (n = 999). HBV serological markers [antibody to HBV core antigen, HBV surface antigen (HBsAg), antibody to HBV surface antigen, HBV ‘e’ antigen (HBeAg), and antibody to hepatitis B ‘e’ antigen] and plasma HBV DNA viral load were measured retrospectively on stored baseline samples. Logistic regression was used to examine associations with baseline demographic and clinical factors. The rate of HBsAg positivity was significantly higher in Zimbabwe than Uganda (12.2 vs. 7.7%, adjusted odds ratio = 1.54, P < 0.001) despite a similar prevalence of antibody to HBV core antigen (56.3 vs. 52.4%) in the two settings. Overall, HBsAg positivity was associated with male sex (adjusted odds ratio = 1.54, P < 0.001) but not with age, WHO disease stage, or CD4+ cell count. HBeAg was detected among 37% of HBsAg-positive patients, with higher rates among those with advanced WHO stage (P = 0.02). Also in HBsAg-positive patients, HBV DNA was undetectable in 21%, detectable but below the level of quantification in 14%, and quantifiable in 65%. A total of 96% of HBeAg-positive and 70% of HBeAg-negative patients had detectable HBV DNA; 92 and 28% of patients, respectively, had HBV DNA viral load more than 2000 IU/ml. High rates of HBV coinfection were observed, highlighting the importance of ensuring that coinfected patients receive an antiretroviral regimen, whether first-line or not, that is active against both viruses.