9TH EUROPEAN AIDS CONFERENCE (EACS)
1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP

 October 25 - 29, 2003 Warsaw • Poland

13.1 Hepatitis B

 F9/3 - HEPATITIS B (HBV) IN THE EUROSIDA COHORT: PREVALENCE AND IMPACT ON MORTALITY, AIDS PROGRESSION AND RESPONSE TO HAART
Konopnicki D.1, * De Wit S.1, Antunes F., Ledergerber B., Katlama C., Zilmer K., Kirk O.2, Vella S., Mocroft A.2, Lundgren J.D.2, for the EuroSIDA Group
  1 Saint-Pierre University Hospital, Brussels, Belgium,2 Copenhagen HIV Programme, Denmark,3 University Hospital Zürich, Zürich, Switzerland,4 Hopital de la Pitié-Salpetriére, Paris, France,5 West-Tallinn Central Hospital, Tallinn, Estonia,6 EuroSIDA Coordination Centre, Copenhagen HIV Programme, Hvidovre, Denmark,7 Istituto superiore di Santà, Rome, Italy,8 HIV Research Unit, Royal Free and University College Medical Schools, London, UK
 

Background: Whether HBV co-infection affects outcome of patients treated with HAART remains unclear.

Objectives: We assessed HBsAg prevalence and survival, clinical progression and response to HAART according to HBsAg status.

Results: Among 5,883 patients tested for HbsAg at time of recruitment in EuroSIDA, 530 patients (9%) were positive. The highest prevalence was found in Argentina (17.8%) vs Northern (9.7%), Central (9.2%), Southern (9.1%) and Eastern Europe (6%) (p=0.0016). There were more males and HIV homosexual transmission among HbsAg-pos subjects (p<0.0001). Median CD4 count at recruitment was lower in HbsAg-pos persons (234) vs HBsAg-neg (274 x 106/l;p<0.0001). Coinfection with HCV was found in 158 HbsAg-pos (29.8%) and 1363 HBsAg-neg patients (25.5%) (p=0.023). Incidence of any new AIDS diagnosis was higher for HbsAg-pos vs HbsAg-neg subjects (13.1 vs 4.1/100 person-years) but this was not significant after adjustment for CD4, age, AIDS diagnosis, HAART, risk group, gender, ethnic origin, region of Europe, date of recruitment, and HCV status(Poisson regression model). The incidence of global and liver-related mortality were significantly higher in HbsAg-pos vs HbsAg-neg patients (12 vs 2.6 and 0.5 vs 0.2 /100 person-years respectively), and remained significantly higher in multivariate analysis (including HCV status) with incidence rate ratios of 1.55 (global;95%CI:1.24-1.93) and 3.77 (liver-related mortality;2.07-6.87). HbsAg status did not influence virological or immunological response among the 1752 subjects starting HAART.

Conclusion: The prevalence of HBV-HIV co-infection is 9% in the EuroSIDA cohort. HBV status does not influence virological and immunological responses to HAART but significantly increases overall and liver-related mortality.

Presenting Author: MD Stephane De Wit, Saint-Pierre University Hospital, rue Haute 322, 1000, Brussels, Belgium, Phone: 00 32 2 535 41 30

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