Baseline HBsAg quantitative and CD4 T cell counts are associated with HBsAg loss in people living with HIV/HBV coinfection after combined antiretroviral therapy.

BACKGROUND

Achieving Hepatitis B surface antigen (HBsAg) loss is a significant goal for chronic hepatitis B patients. This study aims to evaluate HBsAg loss in individuals with HIV/HBV coinfection and explore the association of clinical variables with this outcome.

METHODS

We enrolled 138 individuals coinfected with HIV/HBV and 480 HBV mono-infected individuals who initiated antiviral treatment. We employed Kaplan-Meier analysis to compare the rate of HBsAg loss between individuals with HIV/HBV coinfection and those with HBV mono-infection. In the HIV/HBV coinfected cohort, we used Cox proportional hazards models to assess the association between various factors and the incidence of HBsAg loss.

RESULTS

The cumulative HBsAg loss rate was higher among HBV/HIV coinfected individuals (13 patients, 11.5% at year 3) compared to HBV mono-infected individuals (1 patient, 0.6%) after antiviral therapy. In the HIV/HBV coinfected cohort, the multivariable analysis revealed that lower baseline HBsAg level (HR 0.53; 95% CI 0.38-0.74, p<0.001) and baseline CD4 T cell counts < 180 cells/uL (HR 0.32; 95% CI 0.10-0.96, p=0.042) were associated with an increased indicator of HBsAg loss. Additionally, the receiver-operating characteristic curve analysis indicated an area under the curve of 0.771 for baseline HBsAg levels and 0.758 for baseline CD4 cell counts at year 1 in predicting HBsAg loss.

CONCLUSIONS

After antiretroviral therapy, HIV/HBV coinfected adults achieve higher rates of HBsAg loss. Baseline HBsAg quantitative and CD4 T cell counts are associated with HBsAg loss in individuals with HIV/HBV coinfection after combined antiretroviral therapy and may inform treatment decisions.