Liver Fibrosis by Transient Elastography and Virologic Outcomes After Introduction of Tenofovir in Lamivudine-Experienced Adults With HIV and Hepatitis B Virus Coinfection in Ghana

Simple item page
dc.contributor.authorStockdale, Alexander J.
dc.contributor.authorPhillips, Richard Odame
dc.contributor.authorBeloukas, Apostolos
dc.contributor.authorAppiah, Lambert Tetteh
dc.contributor.authorChadwick, David
dc.contributor.authoret. al
dc.date.accessioned2020-01-08T17:08:15Z
dc.date.accessioned2023-04-19T01:39:12Z
dc.date.available2020-01-08T17:08:15Z
dc.date.available2023-04-19T01:39:12Z
dc.date.issued2015-05-28
dc.descriptionAn article published by Oxford University Pressen_US
dc.description.abstractBackground. Antiretroviral treatment (ART) programs in sub-Saharan Africa have for many years included lamivudine as the sole hepatitis B virus (HBV) inhibitor. Long-term outcomes and the effects of introducing tenofovir as part of ART in these populations have not been characterized. Methods. The study comprised a cross-sectional analysis of 106 human immunodeficiency virus (HIV)/HBV– coinfected subjects maintained on lamivudine, as well as a prospective analysis of 76 lamivudine-experienced subjects who introduced tenofovir. Patients underwent assessment of liver fibrosis by transient elastography (TE) and testing to characterize HIV type 1 (HIV-1) and HBV replication. Results. After a median of 45 months of lamivudine treatment, HIV-1 RNA and HBV DNA were detectable in 35 of 106 (33.0%) and 54 of 106 (50.9%) subjects, respectively, with corresponding drug resistance rates of 17 of 106 (16.0%) and 31 of 106 (29.2%), respectively. Median TE values were 5.7 kPa (interquartile range, 4.7–7.2 kPa) and independently associated with HBV DNA load, aspartate aminotransferase levels, and platelet counts; 13 of 106 (12.3%) subjects had TE measurements >9.4 kPa. Twelve months after the first assessment, and a median of 7.8 months after introducing tenofovir, HBV DNA levels declined by a mean of 1.5 log10 IU/mL (P < .001). TE values changed by a mean of −0.2 kPa (P = .097), and declined significantly in subjects who had pretenofovir HBV DNA levels >2000 IU/mL (mean, −0.8 kPa; P = .048) or TE values >7.6 kPa (mean, −1.2 kPa; P = .021). HIV-1 RNA detection rates remained unchanged. Conclusions. A proportion of HIV/HBV-coinfected patients on long-term lamivudine-containing ART had poor HIV and HBV suppression, drug resistance, and TE values indicative of advanced liver fibrosis. Tenofovir improved HBV control and reduced liver stiffness in subjects with high HBV DNA load and TE values.en_US
dc.description.sponsorshipKNUSTen_US
dc.identifier.citationOxford University Pressen_US
dc.identifier.urihttps://ir.knust.edu.gh/handle/123456789/11862
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.subjecthepatitis B; lamivudine; tenofovir; transient elastography; Africa.en_US
dc.titleLiver Fibrosis by Transient Elastography and Virologic Outcomes After Introduction of Tenofovir in Lamivudine-Experienced Adults With HIV and Hepatitis B Virus Coinfection in Ghanaen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Liver Fibrosis by Transient Elastography and Virologic Outcomes After Introduction of Tenofovir in Lamivudine-Experienced Adults With HIV and Hepatitis B Virus Coinfection in Ghana.pdf
Size:
307.57 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 2 of 2
Thumbnail Image
Name:
license.txt
Size:
1.73 KB
Format:
Item-specific license agreed to upon submission
Description:
Download
Thumbnail Image
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed to upon submission
Description:
Download
Collections
Articles