Journal Article

Antiretroviral Therapy for Hepatitis B Virus-HIV-Coinfected Patients: Promises and Pitfalls

Vivian Levy and Robert M. Grant

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 7, pages 904-910
Published in print October 2006 | ISSN: 1058-4838
Published online October 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/507532
Antiretroviral Therapy for Hepatitis B Virus-HIV-Coinfected Patients: Promises and Pitfalls

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Coinfections with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are common globally. HIV infection modifies the course of HBV infection by increasing rates of chronicity, prolonging HBV viremia, and increasing liver-related morbidity. To minimize the emergence of HIV and/or HBV resistance, as well as the emergence of liver enzyme flares, the treatment of both infections should be coordinated. Lamivudine or emtricitabine monotherapy readily selects resistant strains in the YMDD motif of the polymerase gene. Adefovir monotherapy has moderate effectiveness in HIV-HBV-coinfected patients who have YMDD mutation. If HBV treatment can be deferred until combination antiretroviral therapy for HIV infection is needed, the combination of tenofovir plus lamivudine or emtricitabine provides potent HBV therapy and a solid backbone for HIV combination antiretroviral therapy, and it likely decreases the emergence of HBV resistance.

Journal Article.  4766 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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