Monitoring and risk of hepatitis B reactivation and hepatitis flare during tenofovir interruption among people with HIV and hepatitis B
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Le résumé fourni par la source
OBJECTIVE: To assess hepatitis B virus (HBV) monitoring, HBV reactivation and hepatitis flares during tenofovir interruptions among people with HIV and HBV. DESIGN: Cohort study of electronic health records. METHODS: All tenofovir (tenofovir disoproxil fumarate and tenofovir alafenamide) interruptions among people with HIV and positive HBV surface antigen (HBsAg) or positive HBV core antibody (HBcAb) were categorized by reactivation risk [high: HBsAg+; moderate: HBsAg-/HBcAb+/surface antibody (HBsAb) negative; low: HBsAg-/HBcAb+/HBsAb+]. Incidence rates of HBV reactivation and hepatitis flare were assessed with Poisson regression. RESULTS: Among 5343 individuals with HIV and HBV, there were 6252 tenofovir interruptions (11% high risk, 19% moderate risk, 69% low risk). During the interruptions, HBV DNA/HBsAg testing was infrequent (high: 52%/25%; moderate: 8%/31%, low: 5%/28%), although alanine transaminase (ALT) testing was performed during nearly all interruptions. The HBV reactivation rate was 9.59 per 100 person-years [95% confidence interval (CI): 7.91-11.64] during high-risk, 0.58 (0.36, 0.91) during moderate-risk, and 0.04 (0.02, 0.11) during low-risk interruptions. The HBV reactivation with hepatitis flare incidence rate was much lower, especially in the high-risk group (3.06 per 100 person-years; 95% CI: 2.19-4.29). CONCLUSIONS: In this large US cohort of people with HIV and HBV, tenofovir interruptions were common and HBV monitoring was sub-optimal. HBV reactivation rates were highest among the high-risk group, but much lower among the moderate-risk and low-risk groups. However, some reactivations were likely missed due to low monitoring frequency. Primary and HIV care providers must incorporate HBV monitoring in their standard of care and proceed with caution if considering a tenofovir interruption for people with HIV and HBV.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Monitoring and risk of hepatitis B reactivation and hepatitis flare during tenofovir interruption among people with HIV and hepatitis B
- Date Crossref
- 22/09/2025
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Icahn School of Medicine at Mount Sinai pays non établi dans la noticeUniversité ou école supérieure
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Dayforce (United States) pays non établi dans la noticeEntreprise
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AIDS Healthcare Foundation pays non établi dans la noticeOrganisation à but non lucratif
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NYU Langone Health pays non établi dans la noticeÉtablissement de santé
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Philadelphia Fight pays non établi dans la noticeOrganisation à but non lucratif
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Oyster Point Family Health Center pays non établi dans la noticeStructure de recherche
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Gilead Sciences (United States) pays non établi dans la noticeEntreprise
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Epividian pays non établi dans la noticeInstitution
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Whole Family Health Center pays non établi dans la noticeÉtablissement de santé
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Inc. Gilead Sciences pays non établi dans la noticeEntreprise
Icahn School of Medicine at Mount Sinai, Dayforce (United States) et AIDS Healthcare Foundation, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.