Elevated Pre-Treatment IL-18 Level is associated with HBeAg Seroconversion in HIV-HBV Coinfection. Issue 6 (August 2017)

• Record Type: Journal Article
• Authors: Li, Yijia; Xie, Jing; Wang, Huanling; Han, Yang; Wang, Nidan; Thio, Chloe L; Li, Taisheng
• Is Part Of: Antiviral therapy. Volume 22:Issue 6(2017)
• Page Start: 523
• Page End: 527
• Publication Date: 2017-08
• Subjects: Antiviral agents -- Periodicals; Antiviral Agents -- therapeutic use; Virus Diseases -- therapy; Viruses -- drug effects; Antiviral agents; Periodical; Electronic journals; Periodicals; 616.9106
• DOI: 10.3851/IMP3136
• Languages: English
• ISSNs: 1359-6535

Abstract

Background: In HBV-infected patients, hepatitis B e antigen (HBeAg) seroconversion is associated with better outcomes. Interleukin-18 (IL-18) controls hepatitis B replication in a mouse model. However, its role in treatment response in HIV–HBV-coinfected patients is unknown. Methods: We enrolled 35 treatment-naive, HBeAg-positive, HIV–HBV-coinfected patients. HBV DNA, HIV RNA, CD4 + T-cell count, HBV surface antigen (HBsAg) quantification (qHBsAg), HBeAg quantification (qHBeAg) and IL-18 levels were measured prior to, at 24 and 48 weeks of HBV-active combination antiretroviral therapy (cART). Multivariate Poisson regression models with robust standard errors were used to determine factors associated with HBeAg seroconversion. Results: Twenty-one patients received tenofovir (TDF) + lamivudine (3TC) based cART while 14 patients received 3TC-based cART. After 48 weeks of treatment, 10 patients experienced HBeAg seroconversion. Compared with non-seroconverters, seroconverters had higher median HIV RNA (5.22 versus 4.58 log copies/ml; P =0.030), lower median qHBsAg (3.97 versus 4.76 log IU/ml; P =0.011), lower median qHBeAg (1.61 versus 3.01 log PEIU/ml; P =0.004) and marginally higher median IL-18 (2.70 versus 2.53 log pg/ml; P =0.068) prior to ART. In the multivariate regression, higher baseline IL-18 (adjusted relative risk [aRR] 2.99 per 1 log pg/ml increase; P =0.035), high HIV RNA (aRR 1.84 per 1 log copies/ml; P =0.029) and low qHBeAg (aRR 0.71 per 1 log PEIU/ml; P =0.029) were significantly associated with HBeAg seroconversion. Conclusions: In HIV–HBV-coinfected patients with HBeAg positivity, higher IL-18 levels, HIV RNA load, as well as low qHBeAg prior to cART were associated with HBeAg seroconversion.