Usman Rahim, MD
Detroit, Michigan
Usman Rahim, MD1, Sindhuri Benjaram, MD2, Wadah Ameen, MD3, Murray N. Ehrinpreis, MD, FACG2, Milton Mutchnick, MD2, Paul Naylor, PhD2
1Wayne State University, Detroit, MI; 2Wayne State University School of Medicine, Detroit, MI; 3Wayne State University, Melvindale, MI
Introduction: TThe prevalence of Hepatitis B virus (HBV) infection in the US is estimated at 2 million and remains a public health challenge. The incidence of HBV is high in African Americans (AA), but most studies on HBV are in Asian population. Majority of patients in our Gastroenterology academic clinics are AA. We aimed to evaluate characteristics and treatment outcomes of chronic HBV in AA patients with or without co-infection with HIV.
Methods: We identified 149 patients with a visit between 2016-2018. Majority (124/149= 83%) of patients had one previous visit at least two years prior, such that outcomes of treatment could be evaluated (25 patients excluded). All HIV-HBV co-infected patients were treated with tenofovir containing HART regimens and the majority of mono-infected were also treated with tenofovir.
Results: There were 62 AA and 2 non-AA patients with HIV coinfection, and 53 AA, 14 Asian, and 18 non-AA/non-Asian patients who were treated. Coinfected patients were more likely to be male (90% vs. 54%). The liver relevant data at entry for the 115 AA patients reported in this study is shown in table 1. Co-infected and Mono-infected had patients who were on treatment or projected to be treated had had greater degrees of elevated HBV DNA, Inflammation, and fibrosis compared to HBV patients who were not subsequently treated. Co-infected and mono-infected patients were equally likely to be treated. In evaluation of response to treatment, only patients treated for at least 2 years were included (18 patients were excluded). Response to treatment is shown in table 2. The number of patients with HBV DNA >2000 I.U. (Hi HBV DNA) and high ALT declined significantly in both treatment groups. Fibrosis defined by APRI and FIB-4 also declined but was only statistically significant in the co-infected patients. When correlating decline with time on therapy, only ALT (p< 0.01) declined in HIV-HBV co infected patients. ALT, APRI and FIB-4 all declined with time on treatment in mono-infected patients, although only Fib-4 was significant at p< 0.05
Discussion: AA individuals with HBV, regardless of co-infection with HIV, respond to anti-viral therapy with a decline in HBV DNA, ALT, APRI and FIB-4. Further studies evaluating outcomes as defined by continued assessment of liver by ultrasound, serum based fibrosis specific assays, and fibroscan are required to more accurately define the positive effects of anti-viral therapy, especially in HIV coinfected AA.
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Citation: Usman Rahim, MD; Sindhuri Benjaram, MD; Wadah Ameen, MD; Murray N. Ehrinpreis, MD, FACG; Milton Mutchnick, MD; Paul Naylor, PhD. P1535 - TREATMENT OF CHRONIC HBV IN AFRICAN AMERICAN PATIENTS WITH AND WITHOUT CO-INFECTION WITH HIV. Program No. P1535. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.