Tabak Fehmi, Yıldız Sevgi Dilek, Zerdali Esra, Kurt Ahmet Furkan, Kumbasar Karaosmanoğlu Hayat, Meriç Koç Meliha, Gunduz Alper, Öncül Ahsen, Nakir İnci Yilmaz, Canpolat Ünlü Esra, Altuntaş Aydın Ozlem, Mete Bilgul
Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Int J STD AIDS. 2025 Jun 18:9564624251352345. doi: 10.1177/09564624251352345.
BackgroundHepatitis B (HBV) infection affects 4%-14% of people with HIV infection in Turkey. Tenofovir alafenamide (TAF) is highly effective in treatment of HIV infection. While it is active against HBV, data on the use in HIV-HBV co-infection are limited.Patients and MethodsWe analyzed the efficacy of tenofovir disoproxil fumarate (TDF)- and TAF-containing regimens in patients with HIV-HBV co-infection from six centers in Istanbul, Turkey. The results of the cohort of 36 months were presented.Results259 patients were enrolled: 146 and 113 were receiving TAF- and TDF-containing regimens respectively. Baseline characteristics were comparable except TAF-containing group was older; had higher CD4 cell count and lower rate of CD4 count ≤200 cells/μL. Baseline HIV-RNA were 8.2 log copies/mL and 6.8 log in TAF- and TDF-containing groups, respectively ( = .059) and HBV-DNA levels were 8.1 log IU/mL in both groups. Thirty-eight and 39% of the patients were HBeAg-positive. After 36 months, undetectable HBV-DNA was noted in 88% and 87%, and undetectable HIV-RNA in 85% and in 83% of TAF and TDF-containing groups, respectively. The increase in mean CD4 cell was significant in both groups: Δ = 311 cells/μL in TAF- and Δ = 393 cells/μL in TDF-containing groups. Rates of HBeAg loss (63% vs 57%), HBeAg seroconversion (35% vs 29%), HBsAg loss (29% vs 27%), and HBsAg seroconversion (23% vs 16%) were comparable at 36 months of therapy.ConclusionThis real-life study showed that both TAF- and TDF-containing regimens are effective in co-infected patients. The rates of HBsAg loss seemed higher than those in HBV-monoinfected patients.
背景
在土耳其，乙型肝炎（HBV）感染影响4%-14%的HIV感染者。替诺福韦艾拉酚胺（TAF）在治疗HIV感染方面非常有效。虽然它对HBV有活性，但关于其在HIV-HBV合并感染中使用的数据有限。
患者与方法
我们分析了来自土耳其伊斯坦布尔六个中心的HIV-HBV合并感染患者中含富马酸替诺福韦二吡呋酯（TDF）和TAF方案的疗效。呈现了36个月队列的结果。
结果
共纳入259例患者：分别有146例和113例接受含TAF和TDF的方案。除含TAF组年龄较大、CD4细胞计数较高且CD4计数≤200细胞/μL的比例较低外，基线特征具有可比性。含TAF组和含TDF组的基线HIV-RNA分别为8.2 log拷贝/mL和6.8 log（P = 0.059），两组的HBV-DNA水平均为8.1 log IU/mL。38%和39%的患者HBeAg阳性。36个月后，含TAF组和含TDF组分别有88%和87%的患者HBV-DNA检测不到，85%和83%的患者HIV-RNA检测不到。两组平均CD4细胞的增加均显著：含TAF组Δ = 311细胞/μL，含TDF组Δ = 393细胞/μL。治疗36个月时，HBeAg消失率（63%对57%）、HBeAg血清学转换率（35%对29%）、HBsAg消失率（29%对27%）和HBsAg血清学转换率（23%对16%）具有可比性。
结论
这项真实世界研究表明，含TAF和TDF的方案对合并感染患者均有效。HBsAg消失率似乎高于HBV单一感染患者。
