HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG Switch
Hepatitis B Core antibody (HBcAb) positivity is the surrogate marker of hepatitis B occult infection. This condition is not a contraindication for switching to two-drug (2DR) antiretroviral therapy; however, the removal of tenofovir may contribute to poor control of HBV replication. A multicentre re...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
|
| Series: | Viruses |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1999-4915/16/3/348 |
| _version_ | 1797239088529539072 |
|---|---|
| author | Vincenzo Malagnino Tiziana Mulas Elisabetta Teti Monica Basso Mario Giobbia Nicholas Geremia Giuliana Battagin Yasmine Abi Aad Jean-Paul Vincensini Marco Iannetta Saverio Giuseppe Parisi Loredana Sarmati Karine Lacombe |
| author_facet | Vincenzo Malagnino Tiziana Mulas Elisabetta Teti Monica Basso Mario Giobbia Nicholas Geremia Giuliana Battagin Yasmine Abi Aad Jean-Paul Vincensini Marco Iannetta Saverio Giuseppe Parisi Loredana Sarmati Karine Lacombe |
| author_sort | Vincenzo Malagnino |
| collection | DOAJ |
| description | Hepatitis B Core antibody (HBcAb) positivity is the surrogate marker of hepatitis B occult infection. This condition is not a contraindication for switching to two-drug (2DR) antiretroviral therapy; however, the removal of tenofovir may contribute to poor control of HBV replication. A multicentre retrospective cohort study investigated the impact of HBcAb positivity on HIV control in patients switching to a 2DR with Lamivudine and Dolutegravir (3TC-DTG). In this study, a comparison analysis was conducted between HBcAb-positive and -negative PLWH regarding HIV-RNA suppression, considering: (1): Target Not Detected (TND) < 20 cp/mL; (2) Target Detected (TD) < 20 cp/mL; and (3) Detectable > 20 cp/mL and <50 cp/mL and >50 copies/mL. A total of 267 patients on 2DR with 3TC-DTG were included. In comparison to HBcAb-negative, HBcAb-positive patients were older (45 years [35–54]) and had a lower CD4+ nadir (248 vs. 349 cells/mmc, <i>p</i> = 0.007). No difference in the maintenance of virological suppression was present in the two groups of patients before the switch. Although no patient had an HIV-RNA > 20 cp/mL after the switch, significantly fewer HBcAb-positive compared with -negative subjects resulted in TND at 12, 24, and 36 months after the switch: 52 (69.3%) versus 164 (85.4%), <i>p</i> = 0.004, 50 [72.5%] versus 143 [89.9%], <i>p</i> = 0.001, and 30 [66.7%] versus 90 [92.8%], <i>p</i> = 0.001, respectively. HBcAb positivity is associated with an increased risk of suboptimal HIV suppression during the 36 months after 3TC/DTG simplification. This finding reinforces the relevance of the OBI condition in PLWH and raises the issue of careful virological monitoring of such cases. |
| first_indexed | 2024-04-24T17:45:59Z |
| format | Article |
| id | doaj.art-4a4474e3306940a889baefea65d2e6df |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-04-24T17:45:59Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-4a4474e3306940a889baefea65d2e6df2024-03-27T14:07:37ZengMDPI AGViruses1999-49152024-02-0116334810.3390/v16030348HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG SwitchVincenzo Malagnino0Tiziana Mulas1Elisabetta Teti2Monica Basso3Mario Giobbia4Nicholas Geremia5Giuliana Battagin6Yasmine Abi Aad7Jean-Paul Vincensini8Marco Iannetta9Saverio Giuseppe Parisi10Loredana Sarmati11Karine Lacombe12Infectious Disease Unit, Policlinico Tor Vergata of Rome, 00133 Rome, ItalyInfectious Disease Unit, Policlinico Tor Vergata of Rome, 00133 Rome, ItalyInfectious Disease Unit, Policlinico Tor Vergata of Rome, 00133 Rome, ItalyDepartment of Molecular Medicine, University of Padova, 35128 Padova, ItalyInfectious Disease Unit, Ospedale di Treviso, 31100 Treviso, ItalyInfectious Disease Unit, Ospedale di Venezia, 30122 Venezia, ItalyInfectious Disease Unit, Ospedale di Vicenza, 36100 Vicenza, ItalyHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et Tropicales, Cedex 12, 75571 Paris, FranceHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et Tropicales, Cedex 12, 75571 Paris, FranceInfectious Disease Unit, Policlinico Tor Vergata of Rome, 00133 Rome, ItalyDepartment of Molecular Medicine, University of Padova, 35128 Padova, ItalyInfectious Disease Unit, Policlinico Tor Vergata of Rome, 00133 Rome, ItalyHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et Tropicales, Cedex 12, 75571 Paris, FranceHepatitis B Core antibody (HBcAb) positivity is the surrogate marker of hepatitis B occult infection. This condition is not a contraindication for switching to two-drug (2DR) antiretroviral therapy; however, the removal of tenofovir may contribute to poor control of HBV replication. A multicentre retrospective cohort study investigated the impact of HBcAb positivity on HIV control in patients switching to a 2DR with Lamivudine and Dolutegravir (3TC-DTG). In this study, a comparison analysis was conducted between HBcAb-positive and -negative PLWH regarding HIV-RNA suppression, considering: (1): Target Not Detected (TND) < 20 cp/mL; (2) Target Detected (TD) < 20 cp/mL; and (3) Detectable > 20 cp/mL and <50 cp/mL and >50 copies/mL. A total of 267 patients on 2DR with 3TC-DTG were included. In comparison to HBcAb-negative, HBcAb-positive patients were older (45 years [35–54]) and had a lower CD4+ nadir (248 vs. 349 cells/mmc, <i>p</i> = 0.007). No difference in the maintenance of virological suppression was present in the two groups of patients before the switch. Although no patient had an HIV-RNA > 20 cp/mL after the switch, significantly fewer HBcAb-positive compared with -negative subjects resulted in TND at 12, 24, and 36 months after the switch: 52 (69.3%) versus 164 (85.4%), <i>p</i> = 0.004, 50 [72.5%] versus 143 [89.9%], <i>p</i> = 0.001, and 30 [66.7%] versus 90 [92.8%], <i>p</i> = 0.001, respectively. HBcAb positivity is associated with an increased risk of suboptimal HIV suppression during the 36 months after 3TC/DTG simplification. This finding reinforces the relevance of the OBI condition in PLWH and raises the issue of careful virological monitoring of such cases.https://www.mdpi.com/1999-4915/16/3/348HBcAb+OBIHIV/HBV |
| spellingShingle | Vincenzo Malagnino Tiziana Mulas Elisabetta Teti Monica Basso Mario Giobbia Nicholas Geremia Giuliana Battagin Yasmine Abi Aad Jean-Paul Vincensini Marco Iannetta Saverio Giuseppe Parisi Loredana Sarmati Karine Lacombe HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG Switch Viruses HBcAb+ OBI HIV/HBV |
| title | HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG Switch |
| title_full | HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG Switch |
| title_fullStr | HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG Switch |
| title_full_unstemmed | HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG Switch |
| title_short | HBcAb Positivity as a Risk Factor for Missing HIV RNA Undetectability after the 3TC+DTG Switch |
| title_sort | hbcab positivity as a risk factor for missing hiv rna undetectability after the 3tc dtg switch |
| topic | HBcAb+ OBI HIV/HBV |
| url | https://www.mdpi.com/1999-4915/16/3/348 |
| work_keys_str_mv | AT vincenzomalagnino hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT tizianamulas hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT elisabettateti hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT monicabasso hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT mariogiobbia hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT nicholasgeremia hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT giulianabattagin hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT yasmineabiaad hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT jeanpaulvincensini hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT marcoiannetta hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT saveriogiuseppeparisi hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT loredanasarmati hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch AT karinelacombe hbcabpositivityasariskfactorformissinghivrnaundetectabilityafterthe3tcdtgswitch |