Journal Article

Impact of tenofovir-containing antiretroviral therapy on chronic hepatitis B in a cohort co-infected with human immunodeficiency virus

Christoph Stephan, Annemarie Berger, Amina Carlebach, Thomas Lutz, Markus Bickel, Stephan Klauke, Schlomo Staszewski and Martin Stuermer

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 56, issue 6, pages 1087-1093
Published in print December 2005 | ISSN: 0305-7453
Published online November 2005 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dki396
Impact of tenofovir-containing antiretroviral therapy on chronic hepatitis B in a cohort co-infected with human immunodeficiency virus

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Objectives: We studied the impact of tenofovir disoproxil fumarate, given as an antiretroviral medication, on patients with chronic hepatitis B virus (HBV) co-infection.

Methods: The polymerase gene-sequence evolution and quantitative HBV loads (HBVL) were observed for 48 weeks in patients taking tenofovir-containing antiretroviral therapy. The patients were grouped according to baseline strata: high-replicative virus (>6 log copies/mL), low-replicative virus at detectable virus loads (<6 log) and HBs-antigen-positive, HBV-DNA-negative individuals.

Results: Thirty-one patients were evaluated. The median decline in 20 patients with high-replicative HBV infection was −5.37 log (range: 3.57–7); 11 out of 20 decreased to undetectable levels (lower limit of detection = < 200 copies/mL) and another three were below 400 copies/mL. Out of six patients with detectable HBV-DNA at week 48 (HBVL result: range 3.36–4.32 log10), we were able to carry out a re-sequence in four patients. We did not observe relevant emerging resistance mutations, or a relevant virus load re-increase from nadir (>+0.5 log). The patients with low-replicative virus (n = 9) and the baseline DNA-negative patients (n = 2) had an undetectable HBV-DNA at week 48. Two patients became HBeAg-negative; one DNA-negative patient became HBsAg-negative.

Conclusions: Tenofovir is effective in treating HBV infection in HIV patients. Patients with high-replicative virus may benefit from this treatment strategy by a reduction in replicative status, a precondition for improved hepatic function. A few patients showed low-level HBV replication. Indicators for clinical HBV-resistance to tenofovir were not observed.

Keywords: tenofovir disoproxil fumarate; lamivudine; YMDD mutation; HBV; HIV

Journal Article.  4292 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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