Intensification with pegylated interferon during treatment with tenofovir in HIV-hepatitis B virus co-infected patients.

In hepatitis B 'e' antigen ( HBeAg) positive patients with hepatitis B virus ( HBV) mono-infection, intensification of nucleos(t)ide analogue treatment with pegylated interferon (Peg IFN) could help induce higher HBeAg seroclearance rates. Our aim was to determine the long-term effect of adding Peg IFN to tenofovir ( TDF)-containing antiretroviral therapy on seroclearance in HBeAg-positive patients co-infected with the human immunodeficiency virus ( HIV) and HBV. In this prospective matched cohort study, 46 patients with 1-year Peg IFN intensification during TDF-containing antiretroviral therapy ( TDF+Peg IFN) were matched 1:1 to controls undergoing TDF without Peg IFN ( TDF) using a time-dependent propensity score based on age, CD4+ count and liver cirrhosis status. Kinetics of HBeAg quantification ( qHBeAg) and hepatitis B surface antigen quantification ( qHBsAg) were estimated using mixed-effect linear regression and time to HBeAg seroclearance or HBsAg seroclearance was modelled using proportional hazards regression. At baseline, previous TDF exposure was a median 39.8 months ( IQR=21.4-59.4) and median qHBeAg and qHBsAg levels were 6.9 PEIU/ mL and 3.72 log10 IU/ mL, respectively ( P>.5 between groups). Median follow-up was 33.4 months ( IQR=19.0-36.3). During intensification, faster average declines of qHBeAg (−0.066 vs −0.027 PEIU/ mL/month, P=.001) and qHBsAg (−0.049 vs −0.026 log10 IU/ mL/month, P=.09) were observed in patients undergoing TDF+Peg IFN vs TDF, respectively. After intensification, qHBeAg and qHBsAg decline was no different between groups ( P=.7 and P=.9, respectively). Overall, no differences were observed in HBeAg seroclearance ( TDF+Peg IFN=13.2 vs TDF=12.6/100 person·years, P=.5) or HBsAg seroclearance rates ( TDF+Peg IFN=1.8 vs TDF=1.3/100 person·years, P=.7). In conclusion, Peg IFN intensification in HBeAg-positive co-infected patients did not lead to increased rates of HBeAg or HBsAg clearance, despite faster declines of antigen levels while on PegIFN. [ABSTRACT FROM AUTHOR]