@article{8e538137e5374f7d82acc26ef6d983d6,
title = "HBV coinfection is associated with reduced CD4 response to antiretroviral treatment in pregnancy",
abstract = "Objective: To evaluate the impact of Hepatitis B virus (HBV) coinfection on response to antiretroviral treatment in pregnant women with HIV. Methods: Retrospective analysis of a large case series of pregnant women with HIV in Italy; outcome measures were CD4 changes, HIV viral load, and main pregnancy outcomes (preterm delivery, low birthweight, intrauterine growth restriction, mode of delivery, and major birth defects). Results: Rate of HBV coinfection among 1462 pregnancies was 12.0%. Compared to the HBV-uninfected, HBV-coinfected women had a significantly lower median CD4 cell gain between first and third trimester (26.5 vs. 60 cells/mm3, p = 0.034), with similar rate of undetectable (<50 copies/ml) HIV-RNA at third trimester (70.5% vs. 65.2%, p = 0.229), and no differences in all the main maternal and infant outcomes. A multivariable linear regression analysis identified four variables significantly and independently associated with a lower CD4 response in pregnancy: HBV coinfection (–35 cells/mm3), being on antiretroviral treatment at conception (–59.7 cells/mm3), AIDS status (–59.8 cells/mm3) and higher first CD4 levels in pregnancy (–0.24 cells per unitary CD4 increase). Conclusions: HBV coinfection had no adverse influence on the main pregnancy outcomes or on HIV viral load suppression in late pregnancy but was associated with a significantly reduced CD4 response in pregnancy. This effect might have clinical relevance, particularly in women with advanced immune deterioration. {\textcopyright} 2017 Informa UK Limited, trading as Taylor & Francis Group.",
keywords = "Antiretroviral treatment, CD4 response, HBV, HIV, HIV viral load, Pregnancy, Pregnancy outcomes, Preterm delivery, CD4 antigen, emtricitabine, lamivudine, tenofovir, virus RNA, adult, antiretroviral therapy, Article, CD4 lymphocyte count, controlled study, female, first trimester pregnancy, hepatitis B, Hepatitis B virus, human, Human immunodeficiency virus infection, Italy, major clinical study, mixed infection, pregnancy, pregnancy outcome, pregnant woman, priority journal, retrospective study, third trimester pregnancy, virus load, CD4+ T lymphocyte, highly active antiretroviral therapy, HIV Infections, immunology, infant, metabolism, odds ratio, treatment outcome, virology, Adult, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes, Coinfection, Female, Hepatitis B, Humans, Infant, Odds Ratio, Pregnancy Outcome, Treatment Outcome, Viral Load",
author = "M. Floridia and G. Masuelli and E. Tamburrini and A. Spinillo and G. Simonazzi and G. Guaraldi and {Degli Antoni}, A.M. and P. Martinelli and V. Portelli and S. Dalzero and M. Ravizza",
note = "Export Date: 6 April 2018 CODEN: HCTIA Correspondence Address: Floridia, M.; Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanit{\`a}, Viale Regina Elena 299, Italy; email: marco.floridia@iss.it Chemicals/CAS: emtricitabine, 137530-41-7, 143491-54-7, 143491-57-0; lamivudine, 134678-17-4, 134680-32-3; tenofovir, 147127-19-3, 147127-20-6 Funding details: ISS, Istituto Superiore di Sanit{\`a} Funding details: H85E08000200005, Ministero della Salute Funding details: AIFA, Agenzia Italiana del Farmaco, Ministero della Salute Funding text: This work was supported by Agenzia Italiana del Farmaco, Ministero della Salute [grant number H85E08000200005]. We thank Cosimo Polizzi and Alessandra Mattei of the Istituto Superiore di Sanit? in Rome, Italy, for providing technical secretarial for this study. No compensation was received for this contribution. References: Yang, R., Gui, X., Xiong, Y., Gao, S.C., Yan, Y., Impact of hepatitis B virus infection on HIV response to antiretroviral therapy in a Chinese antiretroviral therapy center (2014) Int J Infect Dis, 28, pp. 29-34; Sarfo, F.S., Kasim, A., Phillips, R., Geretti, A.M., Chadwick, D.R., Long-term responses to first-line antiretroviral therapy in HIV and hepatitis B co-infection in Ghana (2014) Journal of Infection, 69, pp. 481-489; Wang, H., Li, Y., Zhang, C., Immunological and virological responses to combined antiretroviral therapy in HIV/hepatitis B virus-coinfected patients from a multicenter cohort (2012) AIDS, 26, pp. 1755-1763; van Griensven, J., Phirum, L., Choun, K., Thai, K., De Wegghelere, A., Lynen, L., Hepatitis B and C Co-infection among HIV-infected adults while on antiretroviral treatment: long-term survival, CD4 cell count recovery and antiretroviral toxicity in Cambodia (2014) PLoS One, 9 (2), p. e88552; Wandeler, G., Gsponer, T., Bihl, F., Hepatitis B virus infection is associated with impaired immunological recovery during antiretroviral therapy in the Swiss HIV cohort study (2013) J Infectious Diseases, 208, pp. 1454-1458; Okwuraiwe, A.P., Audu, R.A., Salu, O.B., Immunological and virological response to haart in HIV-1 patients co-infected with hepatitis B and C viruses (2012) West Afr J Med, 31, pp. 124-128; Weimer, L.E., Fragola, V., Floridia, M., Response to raltegravir-based salvage therapy in HIV-infected patients with hepatitis C virus or hepatitis B virus coinfection (2013) J Antimicrob Chemother, 68, pp. 193-199; Floridia, M., Ravizza, M., Tamburrini, E., Diagnosis of HIV infection in pregnancy: data from a national cohort of pregnant women with HIV in Italy (2006) Epidemiol Infect, 134, pp. 1120-1127; Scheuerle, A., Tilson, H., Birth defect classification by organ system: a novel approach to heighten teratogenic signalling in a pregnancy registry (2002) Pharmacoepidemiol Drug Saf, 11, pp. 465-475; Bertino, E., Spada, E., Occhi, L., Neonatal anthropometric charts: the Italian neonatal study compared with other European studies (2010) J Pediatr Gastroenterol Nutr, 51, pp. 353-361; Martin, C.M., Welge, J.A., Shire, N.J., Shata, M.T., Sherman, K.E., Blackard, J.T., Cytokine expression during chronic versus occult hepatitis B virus infection in HIV co-infected individuals (2009) Cytokine, 47, pp. 194-198; Selvaraj, S., Paintsil, E., Virologic and host risk factors for mother-to-child transmission of HIV (2013) Curr HIV Res, 11, pp. 93-101",
year = "2017",
doi = "10.1080/15284336.2016.1276312",
language = "English",
volume = "18",
pages = "54--59",
journal = "HIV Clinical Trials",
issn = "1528-4336",
publisher = "Taylor and Francis Ltd.",
number = "2",
}