Predictors of loss of hepatitis B surface antigen in HIV-infected patients

Table 1 Demographic, virological, immunologic characteristics, and outcomes of HIV and HBV co-infected patients in 2 groups according to HBsAg status

	Persistent HBsAg	Loss of HBsAg	P
Number of patients (%)	205 (90.7)	21 (9.3)
Median age (IQR)	46 (42-51)	41 (33-55)	0.305
Gender (%)			0.353
Female	32 (15.6)	5 (23.8)
Male	173 (84.4)	16 (76.2)
Ethnicity (%)
White	25 (12.2)	3 (14.3)	0.731
Hispanic	42 (20.5)	6 (28.6)	9.404
Black	134 (65.4)	12 (57.1)	0.453
Other	4 (2.0)	0 (0.0)
HIV risk factor (%)
Hetero	59 (28.8)	5 (23.8)	0.630
MSM	81 (39.5)	12 (57.1)	0.118
IDU	27 (13.2)	3 (14.3)	0.747
IDU and hetero	10 (4.9)	0 (0.0)
IDU and MSM	6 (2.9)	0 (0.0)
Other	5 (2.4)	0 (0.0)
Unknown	17 (8.3)	1 (4.8)	1.000
HCV co-infection (%)			0.789
HCV positive	49 (23.9)	4 (19.0)
HAART (%)			0.746
No HAART	30 (14.6)	2 (9.5)
HAART	175 (85.4)	19 (90.5)
ALT baseline			0.469
Median ALT baseline (IQR)	44.50 (26.00-79.00)	24.50 (17.50-100.50)
CD4 baseline
Median CD4 baseline (IQR)	270 (115-439)	271 (63-594)	0.449
CD4 baseline > 500 (%)	25 (12.2)	5 (23.8)	0.078
HIV viral load baseline
Median HIV VL (log) (IQR)	4.47 (3.01-5.45)	4.03 (2.70-5.39)	0.841
HIV VL ≤ 400 (%)	40 (19.5)	3 (14.3)	0.763

Hetero: Heterosexual; MSM: Male sex with male; IDU: Intravenous drug use; HIV: Human immunodeficiency virus; HBV: Hepatitis B virus; HCV: Hepatitis C virus; HBsAg: Hepatitis B surface antigen; HAART: Highly active antiretroviral therapy with dually active agents against both HIV and HBV including lamivudine, tenofovir or both for more than 6 mo; ALT: Alanine aminotransferase; CD4 baseline: CD4 cell count baseline cells/mm³; HIV VL: HIV viral load copies/mL; IQR: Interquartile range.

Table 2 Univariate analysis of factors associated with loss of HBsAg

	P
ALT baseline	0.737
HCV co-infection	0.660
HIV VL baseline	0.981
HIV VL end of follow-up	0.790
CD4 cell counts baseline	0.052
CD4 cell count end of follow-up	0.064
CD4 cell count gain	0.118
HAART	0.764

Table 3 Multivariate Cox regression analysis of factors associated with loss of HBsAg

	Odds ratio (95% CI)	P
ALT baseline
Normal ALT (ref)
Elevated ALT	0.157 (0.013-1.829)	0.139
HCV co-infection
HCV negative (ref)
HCV positive	0.073 (0.002-2.802)	0.160
HIV VL baseline (copies/mL)
HIV VL ≤ 75	3.018 (0.028-325.768)	0.644
HIV VL 76-500	9.195 (0.037-2289.798)	0.431
HIV VL 501-100 000	1.026 (0.009-118.554)	0.991
HIV VL > 100 000 (ref)
HIV VL end of follow up (copies/mL)
HIV VL ≤ 75	1134.708 (0.000-1.43E+151)	0.968
HIV VL 76-500	4403. 835 (0.000-5.55E+151)	0.962
HIV VL 501-100 000	3338.767 (0.000-4.19E+151)	0.963
HIV VL > 100 000 (ref)
CD4 baseline (cells/mm3)
CD4 < 200 (ref)
CD4 200-350	0.983 (0.042-22.809)	0.992
CD4 351-500	0.000 (0.000-1.35E+034)	0.834
CD4 > 500	76.174 (2.233-2598.481)	0.016
CD4 end of follow-up (cells/mm3)
CD4 < 200 (ref)
CD4 200-350	9.113 (0.141-587.310)	0.299
CD4 351-500	0.521 (0.018-15.301)	0.705
CD4 > 500	0.003 (0.000-0.631)	0.034
CD4 gain (cells/mm3)
CD4 gain ≤ 150 (ref)
CD4 gain > 150	2.800 (0.122-64.365)	0.520
HAART
No HAART (ref)
HAART	0.117 (0.004-3.105)	0.199

Data for 226 patients. Data censored at the time of HBsAg loss.