Markers of chronic hepatitis B at patients with HIV-infection and treatment approaches
Abstract
Aim of investigation. Assessment of prevalence of markers of the on-going, transferred or «concealed» CHB-infection at patients with HIV-infection in Moscow and in several regions of the Russian Federation.
Material and methods. In Moscow and in several regions of the Russian Federations analysis of questionnaires of 340 228 patients with HIV-infection staying at dispensary observation at 80 territorial centers of AIDS and infectious diseases prophylaxis has been carried out. The blood samples obtained from 2 754 HIV-infected patients from 8 regions of the Russian Federations and from 240 patients with HIV-infection, observed in Moskovsk city AIDS center were studied. Analysis of the out-patient records of 16 813 patients, observed at this center was carried out. All blood samples were investigated for the presence of НBV, HDV, HCV, HAV-virus markers in serum by enzyme-linked immunoassay and for the presence of RNA HIV, RNA HCV and DNA HBV by polymerase chain reaction.
Results. It was revealed, that CHB markers are detected approximately at 5,5–6,8% of patients with HIV-infection, in most of the cases in combination to CHC or CHD markers. Significant part (25%) of HBsAgpositive HIV-infected inhabitants of Krasnoyarsk region have hepatitis D markers. Frequency of «hidden» CHBinfection at HIV-infected patients was 8,8% in Moscow and 44,4 % – in Krasnoyarsk region.
Conclusion. It is recommended to determine markers of transferred CHB-infection at HIV-infected patients and their presence to test blood for HBV DNA. Observation of patients with combined CHB/HIV infection, not requiring in antiretroviral treatment and CHBs receiving telbivudine treatment, revealed effective suppression of HBV replication and did not influence HIV viral load.
About the Authors
S. I. MaksimovRussian Federation
S. P. Tsarenko
Russian Federation
A. V. Kravchenko
Russian Federation
N. Yu. Gankina
Russian Federation
N. D. Yushchuk
Russian Federation
References
1. Кравченко А.В., Ганкина Н.Ю., Канестри В.Г. и др. Диспансерное наблюдение, лечение и профилактика вирусных гепатитов у подростков и взрослых, больных ВИЧ-инфекцией: Метод. рек. – М., 2007. – 84 с.
2. Кравченко А.В., Ганкина Н.Ю., Канестри В.Г., Максимов С.Л. Тактика лечения хронического гепатита В у больных ВИЧ-инфекцией // Инфекционные болезни. – 2008. – № 2. – С. 88–95.
3. Резолюция Первой Европейской согласительной конференции по лечению хронических гепатитов В и С у ВИЧ-инфицированных // Стандарты медицины. – 2006. – № 1. – С. 39–48.
4. Alberti A., Clumecr N., Collins S. et al. Short statement of the first European consensus conference on the treatment of chronic hepatitis B and C in HIV co-infected patients // J. Hepatol. – 2005. – Vol. 42. – P. 615–624.
5. Alter M.J. Epidemiology of viral hepatitis and HIV coinfection // J. Hepatol. – 2006. – Vol. 44 (suppl. 1). – P. 6–9.
6. Clinical management and treatment of HIV-infected adults in Europe. European AIDS Clinical Society (EACS) Guidelines; Version 5, November 2009: (http:// europeanaidsclinicalsociety.org).
7. Custer B., Sullivan S., Hazlet Th. et al. Global epidemiology of hepatitis B virus // J. Clin. Gastroenterol. – 2004. – Vol. 38. – P. 158–168.
8. Detering K., Constantinescu I., Nedelcu F.D. et al. Prevalence of HBV genotypes in Central and Eastern Europe // J. Med. Virol. – 2008. – Vol. 80, N 10. – P. 1707–1711.
9. Dhedin N., Douvin S., Kuentz M. et al. Reverse seroconversion of hepatitis B after allogenic bone marrow transplantation: a retrospective study of 37 patients with pretransplant anti-Hbs and anti-Hbc.
10. Goldstein S.T., Zhou F., Hadler S.C. et al. A mathematical model to estimate global hepatitis B disease burden and vaccination impact // Int. J. Epidemiol. – 2005. – Vol. 34, N 6. – P. 1329.
11. Guidelines for the Use of Antiretroviral Agents in HIV-1Infected Adults and Adolescents. Developed by the Panel on Clinical Practices for Treatment of HIV Infection convened by the Department of Health and Human Services (DHHS); December 1, 2009: (http://AIDSinfo. nih.gov).
12. Hepatology: A clinical textbook. – 2nd ed. – Mauss, Berg, Rockstroh, Sarrazin, Wedermeyer, 2010. – 486 p.
13. HIV and viral hepatitis coinfection / Eds. V. Soriano, P. Permanyer. – 2007. – 118 p.
14. Lai C.L., Gane E., Hsu C.W. et al. Two-year results from the GLOBE trial in patients with hepatitis B: greater clinical and antiviral efficacy for telbivudine vs lamivudine // Hepatology. – 2006. – Vol. 44. – P. 222. – Abstract 91.
15. Lampertico P., Vigano M., Di Costanzo G. et al. Extended (2 years) treatment with peginterferon alfa-2a [40kd] improves sustained response rates in genotype D patients with HBeAg negative chronic hepatitis B. 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010). – Vienna, Austria. April 14–18, 2010. – Abstract 98.
16. Lee H., Park W. Public health policy for management of hepatitis B virus infection: historical review of recommendations for immunization // Public Health Nurs. – 2010. – Vol. 27, N 2. – P. 148–157.
17. Lee W.M. Hepatitis B virus infection // N. Engl. J. Med. – 1997. – Vol. 337, N 24. – P. 1733–1745.
18. Rawatani T., Suou T., Tajima F. Incidence of hepatitis virus infection and severe liver dysfunction in patients receiving chemotherapy for hematologic malignancies // Eur. J. Hematol. – 2001. – Vol. 67. – P. 45–50.
19. Sulkowski M.S. Viral hepatitis and HIV coinfection // J. Hepatol. – 2008. – Vol. 48. – P. 353–367.
20. Tabor E., Hoofnagle J.H., Smallwood L.A. et al. Studies of donors who transmit posttransfusion hepatitis // Transfusion. – 1979. – Vol. 19, N 6. – P. 725–731.
21. Thio C. Hepatitis B in the HIV-infected patient: epidemiology, natural history and treatment // Semin. Liver Dis. – 2003. – Vol. 23. – P. 125–136.
Review
For citations:
Maksimov S.I., Tsarenko S.P., Kravchenko A.V., Gankina N.Yu., Yushchuk N.D. Markers of chronic hepatitis B at patients with HIV-infection and treatment approaches. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2010;20(5):22-26. (In Russ.)
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