PLoS ONE (Jan 2023)

Hepatitis B care cascade among people with HIV/HBV coinfection in the North American AIDS Cohort Collaboration on Research and Design, 2012-2016.

  • Jessica Kim,
  • Craig W Newcomb,
  • Dena M Carbonari,
  • Jessie Torgersen,
  • Keri N Althoff,
  • Mari M Kitahata,
  • Marina B Klein,
  • Richard D Moore,
  • K Rajender Reddy,
  • Michael J Silverberg,
  • Angel M Mayor,
  • Michael A Horberg,
  • Edward R Cachay,
  • Joseph K Lim,
  • M John Gill,
  • Kara Chew,
  • Timothy R Sterling,
  • Mark Hull,
  • Eric C Seaberg,
  • Gregory D Kirk,
  • Sally B Coburn,
  • Raynell Lang,
  • Kathleen A McGinnis,
  • Kelly A Gebo,
  • Sonia Napravnik,
  • H Nina Kim,
  • Vincent Lo Re,
  • North American AIDS Cohort Collaboration on Research and Design of IeDEA

DOI
https://doi.org/10.1371/journal.pone.0290889
Journal volume & issue
Vol. 18, no. 9
p. e0290889

Abstract

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A care cascade is a critical tool for evaluating delivery of care for chronic infections across sequential stages, starting with diagnosis and ending with viral suppression. However, there have been few data describing the hepatitis B virus (HBV) care cascade among people living with HIV infection who have HBV coinfection. We conducted a cross-sectional study among people living with HIV and HBV coinfection receiving care between January 1, 2012 and December 31, 2016 within 13 United States and Canadian clinical cohorts contributing data to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). We evaluated each of the steps in this cascade, including: 1) laboratory-confirmed HBV infection, 2) tenofovir-based or entecavir-based HBV therapy prescribed, 3) HBV DNA measured during treatment, and 4) viral suppression achieved via undetectable HBV DNA. Among 3,953 persons with laboratory-confirmed HBV (median age, 50 years; 6.5% female; 43.8% were Black; 7.1% were Hispanic), 3,592 (90.9%; 95% confidence interval, 90.0-91.8%) were prescribed tenofovir-based antiretroviral therapy or entecavir along with their antiretroviral therapy regimen, 2,281 (57.7%; 95% confidence interval, 56.2-59.2%) had HBV DNA measured while on therapy, and 1,624 (41.1%; 95% confidence interval, 39.5-42.6) achieved an undetectable HBV DNA during HBV treatment. Our study identified significant gaps in measurement of HBV DNA and suppression of HBV viremia among people living with HIV and HBV coinfection in the United States and Canada. Periodic evaluation of the HBV care cascade among persons with HIV/HBV will be critical to monitoring success in completion of each step.