Adherence to European AIDS clinical society hepatitis B management guidelines in people with HIV: real-world evidence from Spain and Germany.
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Berenguer Juan, Ryan Pablo, Lutz Thomas, Martín-Carbonero Luz, Pérez-Latorre Leire, Vivancos María J, Navarro Jordi, Navarro-Soler Roser, Ferrero Oscar L, Palacios Rosario, Wyen Christoph, Domingo Pere, Monin Malte B, Camino Xavier, Montero Marta, Killer Alexander, Malin Jakob J, Santos Ignacio De Los, Esser Stefan, Morano Luis E, López-Cruz Ian, Valencia Jorge, Vogelmann Roger, Mauss Stefan, Rivero Antonio, Elamouri Fauzi, Hidalgo-Tenorio Carmen, Van Bremen Kathrin, Pérez-Somarriba Juncal, Sanz José, Beer Daniel, Baumgarten Axel, Haberl Annette, Galindo María J, Fariñas María C, Voit Florian, Qurishi Nazifa, Noe Sebastian, Reus Sergio, Khaykin Pavel, Schneeweiss Stephan M, Boyd Anders, De Miguel Marta, Bellón José M, Rockstroh Jürgen K, HDV-Europe Study Group
Аннотация
DESIGN: A multicenter cross-sectional study.
METHODS: We conducted a cross-sectional study in 42 centers in Spain and Germany between June 2024 and March 2025. Chronic HBV infection was defined as at least two positive hepatitis B surface antigen tests obtained more than 6 months apart. Adherence to 2023 European AIDS Clinical Society recommendations regarding anti-HBV treatment, liver enzyme monitoring, HBV-DNA testing, antihepatitis D virus (HDV) screening, and HDV-RNA confirmation was assessed. Hepatocellular carcinoma surveillance was evaluated separately and has been reported elsewhere.
RESULTS: A total of 1235 PWH with chronic HBV infection were included. The median age was 56 years, 84% were men, and 36% were born outside Europe. Overall, 88% had HIV-RNA less than 50 copies/ml, and the median CD4+ cell count was 623 cells/μl. Among participants with available HBV-DNA result, 87% had undetectable HBV-DNA. Guideline-recommended anti-HBV treatment was documented in 88% of individuals. During the previous 12 months, liver enzyme monitoring was performed in 94% and HBV-DNA testing in 71%. Overall, 81% had ever undergone anti-HDV testing and, among anti-HDV-positive individuals, 66% had undergone HDV-RNA testing.
CONCLUSION: Although adherence to several components of HBV care was high, gaps remain in the implementation of current recommendations for PWH, particularly in HBV-DNA monitoring and HDV evaluation. Better integration of these measures into routine HIV care may improve long-term prevention of liver-related complications.