Long-term quantitative hepatitis B surface antigen (HBsAg) trajectories in persons with and without HBsAg loss on tenofovir-containing antiretroviral therapy. HIV Medicine
Begré et al. aimed to evaluate long-term trajectories of quantitative hepatitis B surface antigen (qHBsAg) and HBV (hepatitis B virus) DNA levels in persons with HIV/HBV with and without HBsAg loss during tenofovir-containing antiretroviral therapy (ART) in the SHCS.
The authors included 29 participants with and 29 without HBsAg loss, defined as qHBsAg <0.05 IU/mL. They assessed qHBsAg decline during therapy in both groups and used agglomerative hierarchical clustering to identify different qHBsAg trajectory profiles in persons with HBsAg loss.
The median follow-up time was 11.9 years (IQR 8.4–14.1), and the median time to HBsAg loss was 48 months (IQR 12–96). Among participants with HBsAg loss, 79% had a qHBsAg decline≥1log10IU/mL 2 years after starting tenofovir. The trajectories in qHBsAg levels during tenofovir therapy were heterogeneous, characterized by five distinct profiles. Among participants without HBsAg loss, only 7% had a qHBsAg decline≥1log10IU/ml after 2 years.
In conclusion, the study shows that the majority of persons with HIV/HBV experiencing HBsAg loss have aqHBsAg decline of at least 1 log10IU/mL within 2 years of tenofovir therapy. These data suggest that early qHBsAg level changes precede HBsAg loss during tenofovir-containing ART. However, long-term qHBsAg trajectories among persons who experience HBsAg loss during tenofovir-containing ART were diverse, and HBsAg clearance also occurred more than 5 years after starting tenofovir therapy.