Advanced Liver Disease Events in People with HIV and Hepatitis B Virus Coinfection Initiating Antiretroviral Therapy in the United States

作者：Ching‐Yi Chuo, Woodie Zachry, Melanie de Boer, Laura Telep, Tao Li · 发表于：Infectious Diseases and Therapy · 年份：2025 · DOI：10.1007/s40121-025-01192-5 · 被引用次数：3 · 研究领域：HIV/AIDS drug development and treatment、Hepatitis B Virus Studies、Hepatitis C virus research

INTRODUCTION: HIV/hepatitis B virus (HBV) coinfection elevates the risk of liver-related complications compared to HIV or HBV mono-infections. While some antiretroviral therapy (ART) regimens slow liver disease progression, the long-term effects of tenofovir-based and non-tenofovir-based ART on advanced liver disease events in people with HIV/HBV remain unclear. METHODS: People with HIV/HBV and aged ≥ 18 years or older who initiated ART between April 2016 and January 2024 were included from the US HealthVerity claims database. Advanced liver disease events (cirrhosis, liver decompensation, hepatocellular carcinoma [HCC], and liver transplant) were evaluated overall and individually among people who received tenofovir alafenamide (TAF)-based, tenofovir disoproxil fumarate (TDF)-based, or non-tenofovir-based ART; people with events prior to ART initiation were excluded. The time to advanced liver disease events were estimated with Kaplan-Meier methods. Adjusted hazard ratios and 95% CIs were calculated using Cox proportional hazards models. To evaluate liver function over time, alanine aminotransferase and aspartate aminotransferase levels before and after ART initiation were assessed for up to 1 year using adjusted mixed-effect models. RESULTS: Among 3095 people included, 76% initiated TAF-based, 13% initiated TDF-based, and 11% initiated non-tenofovir-based ART. TAF-based and TDF-based ART had significantly longer times to any advanced liver disease event compared to non-teno...