AIDS Res Hum Retroviruses

Immunorecovery could be attenuated in HIV-hepatitis B virus (HBV) co-infection versus HIV mono-infection during antiretroviral therapy (ART), yet whether it also occurs in individuals from Sub-Saharan Africa without severe co-morbidities is unknown. In this study, 808 HIV-infected patients in Cote d'Ivoire initiating continuous ART were included. Six-month CD4+ count trajectories and the proportion reaching CD4+ T-cell counts >350/mm3, HIV-RNA 104 copies/mL). Co-infected patients with high HBV-DNA replication initiated ART with significantly lower median CD4+ T-cell counts (216/mm3, IQR=150-286) compared to co-infection with low HBV-DNA replication (268/mm3, IQR=178-375) or HIV mono-infection (257/mm3, IQR=194-329) (p=0.003). These patients had significantly faster rates of CD4+ cell count increase from baseline after adjusting for baseline age, WHO stage III/IV and CD4+ cell counts (p=0.04), yet were not more likely to exhibit optimal immunorecovery (82.5% versus 80.0% and 77.9%, respectively) (p=0.8). In conclusion, change in CD4+ cell counts after ART-initiation was accelerated in co-infected patients with high HBV DNA viral loads, but this did not lead to increased rates of optimal immunorecovery