Monitoring and risk of hepatitis B reactivation and hepatitis flare during tenofovir interruption among people with HIV and hepatitis B

作者：Douglas T. Dieterich, Laurence Brunet, Ricky K Hsu, Karam Mounzer, Gerald Pierone, Michael Wohlfeiler, Jennifer S Fusco, Megan S. Dunbar, Joshua Gruber, Leland J. Yee, Catherine Frenette, Travis Lim, Gregory Fusco · 发表于：AIDS · 年份：2025 · DOI：10.1097/qad.0000000000004353 · 被引用次数：9 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Hepatitis Viruses Studies and Epidemiology

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 ...