Long‐term quantitative hepatitis B surface antigen (HBsAg) trajectories in persons with and without HBsAg loss on tenofovir‐containing antiretroviral therapy

Abstract

AbstractObjectivesImproving the understanding of the patterns of quantitative hepatitis B surface antigen (qHBsAg) trajectories associated with HBsAg loss is important in light of novel anti‐hepatitis B virus agents being developed. We evaluated long‐term qHBsAg trajectories in persons with HIV and HBV during tenofovir‐containing antiretroviral therapy in the Swiss HIV Cohort Study.MethodsWe included 29 participants with and 29 without HBsAg loss, defined as qHBsAg <0.05 IU/mL. We assessed qHBsAg decline during therapy in both groups and used agglomerative hierarchical clustering to identify different qHBsAg trajectory profiles in persons with HBsAg loss.ResultsThe median follow‐up time was 11.9 years (IQR 8.4–14.1), and the median time to HBsAg loss was 48 months (IQR 12–96). Among participants with HBsAg loss, 79% had a qHBsAg decline ≥1 log10 IU/mL 2 years after starting tenofovir. The trajectories in qHBsAg levels during tenofovir therapy were heterogeneous, characterized by five distinct profiles. Among participants without HBsAg loss, only 7% had a qHBsAg decline ≥1 log10 IU/ml after 2 years.ConclusionsMost persons with HIV who experienced HBsAg loss had an early decline in qHBsAg levels, with diverse trajectories during long‐term tenofovir therapy. In persons without HBsAg loss, qHBsAg levels remained remarkably stable over time.