14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 78.010 Session: HIV: Opportunistic Infections & Malignancies Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Predictors for hepatic carcinoma surveillance screening in a cohort of hepatitis B and HIV coinfected patients in a large urban HIV clinic A. ADEJUMO 1 , Z. Oshikanlu 2 , V. Sivapalan 1 1 Columbia University College Of Physicians and Surgeons affiliation at Harlem Hospital Center, New York, NY, USA, 2 Columbia University College of Physicians and Surgeons affiliation at Harlem Hospital, New York, NY, USA Background: Co-infection with hepatitis B virus (HBV) and HIV is common. Approximately 70- 90% of HIV-infected individuals have evidence of past or active infection with HBV. It is unclear what predicts the likelihood that patient with active HBV/HIV infection will receive appropriate surveillance screening for hepatic carcinoma. We hypothesized that patients who have successful HIV treatment are likely to have successful hepatic carcinoma surveillance screening. Methods: To evaluate predictors for surveillance screening of hepatic carcinoma within the period of July 2008 to June 2009. A retrospective review of medical records of patients with active HBV and HIV co-infection for hepatic ultrasound, alpha fetoprotein (AFP), liver biopsy, HBV viral load, HBV e Ag screenings and gastroenterologist (GI) referral. Results: Of 77 HIV infected patients whose charts were randomly selected, 55.8% (n =43) obtained care during the study period. The demographic was 58% male (n=25). 7 of 43 patients (n =16.3%) had active HBV infection. All 7 patients were referred for hepatic ultrasound, only 43% (n =3) had the procedure performed with 66% (n =2) abnormal. All 7 patients had AFP screening, hepatitis B DNA measurement, hepatitis B e Ag screening and GI referral. 1of 7 patients had an elevated AFP while all 7 had detectable HBV DNA and 43% (n =3) had positive hepatitis B e antigen. 71% (n =5) had an initial GI evaluation while only 28% (n =2) had >1 GI follow up. 28% (n =2) were no show. None of the 7 patients had liver biopsy. In patients who did not obtain an abdominal ultrasound or who did not follow up with GI or no show, there was no significant difference in the CD4 count range when compared to those who obtained ultrasound or follow with GI. 57% (n =4) of patients had issues with adherence as documented in the chart. All 4 patients did not obtain abdominal ultrasound, 3 did not follow up with GI and 1 was no show. Conclusion: 16.3% of our cohort of HBV/HIV co-infected patients had active HBV infection. Nonadherence to follow up plan is the reason in patients who did not obtain abdominal ultrasound or GI evaluation. CD4 count did not appear to be a predictor of probability to obtain hepatic carcinoma screening. Strategies that improve adherence will likely improve the success of hepatic carcinoma surveillance screening.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 78.011 Session: HIV: Opportunistic Infections & Malignancies Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Virological and biochemical evolution of HIV-HBV co-infected patients treated with tenofovir G. Vidiella 1 , P. Rios 2 , C. Biscayart 3 , S. Castillo 4 , A. Botas 4 , M. Christin 5 , D. Stamboulian 6 , P. Rodriguez Iantorno 4 , C. Vujacich 7 1 FUNCEI., Buenos Aires, Argentina, 2 Hospital B Houssay, Buenos Aires, Argentina, 3 Centros Médicos Dr. Stamboulian, Buenos Aires, Argentina, 4 FUNCEI, Bs. As., Argentina, 5 Clinica Olivos, Bs. As., Argentina, 6 FUNCEI; Clinical Director, Ciudad Autonoma de Buenos Aires, Argentina, 7 FUNCEI, BS.AS., Argentina Background: Tenofovir (TDF) is a nucleotide with dual activity against HIV and hepatitis B (HBV) viruses. Thus, it has become the antiviral of choice for HIV-HBV co-infected patients when treatment for both viral infections is indicated. Methods: We reviewed 19 medical records of patients who received tenofovir as part of the antiviral treatment. Five patients had previously received 3TC (lamivudine) as part of HAART. Immunological parameters were recorded for HIV infection (CD4/mm3), AST, ALT and viral loads for HIV and HBV were followed over an average period of 27 months (range, 3-44m). Results: All patients were male and the median age was 42 years (range, 29-65). Concomitant antiviral medications were 1 NRTI +1 NNRTI (3TC/FTC) in 13 patients, 1 ritonavir-boosted PI + 1 NNRTI in 1 patient, 1 PI + 1 NRTI (3TC or FTC) in 4 patients and 1 IP ritonavir-boosted + 2NRTI (AZT + 3TC) in 1 patient. The mean HBV DNA at baseline was: 6.53 log. Six patients presented at baseline with normal ALT and 13 a mean elevation of AST/ALT x 3,8/x 5. The results of liver biopsy were available for 6 patients: 1 had cirrhosis, 3 mild chronic hepatitis (stage 1), 2 moderate chronic hepatitis (stage 2). 17 patients were HBeAg positive, and two were HBeAg negative at baseline. Seven out of 17 patients underwent HBeAg loss and seroconversion to anti e. Loss of HBsAg was documented in 1 patient. HBV-DNA follow up was available in 17/19 patients (2/19 pending). 13/17 achieved HBV-DNA undetectability (mean 58 weeks). 4/17 reduced their HBV-DNA by a mean of 4.75 log (range: 3.1 to 6.2 log) with a mean follow up of 33 weeks. Among 13 patients who had abnormal ALT at baseline, 9 normalized during the follow up. Among patients previously experienced with 3TC: 4 achieved undetectable HBV DNA and the other decreased 6.2 log from baseline. Conclusion: As pointed out by the international literature, we found a high virological and biochemical efficacy of TDF in HIV-HBV co-infected patients, in terms of HBV antiviral inhibition in both previously treated with 3TC and naive patients.
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