Aurpibul Linda, Kanjanavanit Suparat, Leerapun Apinya, Puthanakit Thanyawee
1 Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
2 Nakornping Hospital, Chiang Mai, Thailand.
J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958218823259. doi: 10.1177/2325958218823259.
Hepatitis B virus (HBV) and HIV coinfection is associated with risk of progression to chronic liver disease. We assessed liver stiffness in HBV-HIV coinfected youths.
A cross-sectional study in HBV-HIV coinfected youths aged 18 to 25 years who received a tenofovir (TDF)-containing antiretroviral therapy regimen for >96 weeks. Measurements included HBV DNA level, HBV serology profiles, and transient elastography (TE). The cutoff for TE results included ≥5.9 kPa for F2-moderate fibrosis, ≥7.4 kPa for F3-severe fibrosis, and ≥9.6 kPa for F4-cirrhosis.
From March to December 2016, 15 HBV-HIV coinfected youths with a median duration on TDF-containing regimens of 3.3 years were enrolled. Five (33%) youths had significant liver fibrosis, 3 with F2-moderate, 1 with F3-advanced fibrosis, and 1 with F4-cirrhosis. Other 5 without liver fibrosis had hepatitis B surface e antigen (HBsAg) and hepatitis B surface e antigen (HBeAg) loss. Higher mean alanine transaminase (ALT) was observed among the group with F2-F4 when compared to those with F0.
Liver fibrosis was evidenced in HBV-HIV coinfected youths in Thailand. Transient elastography might be considered for those who do not achieve HBsAg loss or have persistent ALT elevation while on treatment.
乙型肝炎病毒（HBV）与人类免疫缺陷病毒（HIV）合并感染与进展为慢性肝病的风险相关。我们评估了HBV-HIV合并感染青年的肝脏硬度。
对年龄在18至25岁、接受含替诺福韦（TDF）的抗逆转录病毒治疗方案超过96周的HBV-HIV合并感染青年进行了一项横断面研究。测量指标包括HBV DNA水平、HBV血清学特征和瞬时弹性成像（TE）。TE结果的截断值包括F2-中度纤维化≥5.9 kPa，F3-重度纤维化≥7.4 kPa，F4-肝硬化≥9.6 kPa。
2016年3月至12月，纳入了15名HBV-HIV合并感染青年，其接受含TDF方案的中位时间为3.3年。5名（33%）青年有显著肝纤维化，3名F2-中度纤维化，1名F3-重度纤维化，1名F4-肝硬化。其他5名无肝纤维化的青年出现了乙肝表面抗原（HBsAg）和乙肝e抗原（HBeAg）丢失。与F0组相比，F2-F4组的平均丙氨酸转氨酶（ALT）更高。
泰国的HBV-HIV合并感染青年存在肝纤维化证据。对于治疗期间未实现HBsAg丢失或ALT持续升高的患者，可考虑进行瞬时弹性成像检查。
