SidaGhanaV1, Main, Exploration, bibRecord, 000545

Long-term responses to first-line antiretroviral therapy in HIV and hepatitis B co-infection in Ghana

Identifieur interne : 000545 ( Main/Exploration ); précédent : 000544; suivant : 000546

Long-term responses to first-line antiretroviral therapy in HIV and hepatitis B co-infection in Ghana

Auteurs : Fred Stephen Sarfo [Ghana] ; Adetayo Kasim [Royaume-Uni] ; Richard Phillips [Ghana] ; Anna Maria Geretti [Royaume-Uni] ; David R. Chadwick [Royaume-Uni]

Source :

The Journal of infection [ 0163-4453 ] ; 2014.

RBID : Pascal:14-0264029

Descripteurs français

Pascal (Inist)
- SIDA, Hépatite virale B, Antiviral, Chimiothérapie, Long terme, Antirétroviral, Virus immunodéficience humaine, Ghana.
Wicri :
- geographic : Ghana.

English descriptors

KwdEn :
- AIDS, Antiretroviral agent, Antiviral, Chemotherapy, Ghana, Human immunodeficiency virus, Long term, Viral hepatitis B.

Abstract

Objectives: To observe the long term response to first-line antiretroviral therapy (ART) in HIV and hepatitis B virus (HBV) co-infected patients in Ghana and explore predictors of poor clinical outcomes. Methods: Retrospective cohort study of hepatitis B surface antigen (HBsAg) positive and negative patients receiving predominantly NNRTI-based ART with lamivudine plus either zidovudine or stavudine for up to seven years. Cox proportional hazards and Kaplan Meier survival analyses compared clinical outcomes and identified baseline characteristics predictive of poor outcomes. A mixed effects model compared changes in CD4 counts. Results: A total of 299 HBsAg-positive and 1869 HBsAg-negative patients started ART between 2004 and 2008. Over a median 35 months of follow-up, HBsAg-positive patients were more likely to die or default care than HBsAg-negative patients, aHR 1.36 (95% CI, 1.03-1.80). HBsAg-positive patients were also more likely to develop Grade 3/4 hepatotoxicity than HBsAg-negative patients, HR 1.99 (1.16-3.40) on survival analysis. There was no significant difference in CD4 responses between HBsAg-positive and HBsAg-negative patients. Conclusions: HBsAg-positive patients are at significantly increased risk of adverse clinical outcomes after starting ART. Further studies are warranted to evaluate whether these risks remain now that tenofovir is becoming routinely available in Ghana.

Affiliations:

Ghana, Royaume-Uni

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to stream Main, to step Curation: 000545

Le document en format XML

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<author><name sortKey="Sarfo, Fred Stephen" sort="Sarfo, Fred Stephen" uniqKey="Sarfo F" first="Fred Stephen" last="Sarfo">Fred Stephen Sarfo</name>
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<front><div type="abstract" xml:lang="en">Objectives: To observe the long term response to first-line antiretroviral therapy (ART) in HIV and hepatitis B virus (HBV) co-infected patients in Ghana and explore predictors of poor clinical outcomes. Methods: Retrospective cohort study of hepatitis B surface antigen (HBsAg) positive and negative patients receiving predominantly NNRTI-based ART with lamivudine plus either zidovudine or stavudine for up to seven years. Cox proportional hazards and Kaplan Meier survival analyses compared clinical outcomes and identified baseline characteristics predictive of poor outcomes. A mixed effects model compared changes in CD4 counts. Results: A total of 299 HBsAg-positive and 1869 HBsAg-negative patients started ART between 2004 and 2008. Over a median 35 months of follow-up, HBsAg-positive patients were more likely to die or default care than HBsAg-negative patients, aHR 1.36 (95% CI, 1.03-1.80). HBsAg-positive patients were also more likely to develop Grade 3/4 hepatotoxicity than HBsAg-negative patients, HR 1.99 (1.16-3.40) on survival analysis. There was no significant difference in CD4 responses between HBsAg-positive and HBsAg-negative patients. Conclusions: HBsAg-positive patients are at significantly increased risk of adverse clinical outcomes after starting ART. Further studies are warranted to evaluate whether these risks remain now that tenofovir is becoming routinely available in Ghana.</div>
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	Le SIDA au Ghana (serveur d'exploration)
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Le SIDA au Ghana (serveur d'exploration)

Long-term responses to first-line antiretroviral therapy in HIV and hepatitis B co-infection in Ghana

Long-term responses to first-line antiretroviral therapy in HIV and hepatitis B co-infection in Ghana

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri