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Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV‐coinfected patients: factors associated with response
Author(s) -
Jain M. K.,
Comanor L.,
White C.,
Kipnis P.,
Elkin C.,
Leung K.,
Ocampo A.,
Attar N.,
Keiser P.,
Lee W. M.
Publication year - 2007
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2006.00797.x
Subject(s) - lamivudine , hbeag , emtricitabine , hepatitis b virus , bdna test , virology , medicine , coinfection , hepatitis b , viral load , gastroenterology , hbsag , virus
Summary. As therapy for human immunodeficiency virus (HIV) infection evolves, optimizing hepatitis B virus (HBV) treatment and identifying factors that impact its response in the HIV/HBV‐coinfected population is critical. We identified retrospectively 45 HBV/HIV‐coinfected patients with detectable HBV DNA by the Bayer VERSANT® HBV 3.0 bDNA assay (limit of quantification 2000 copies/mL) at baseline and/or year 1 of therapy. Patients were divided into three groups based on the active HBV agent in their antiretroviral regimen: group 1 ( n = 15) received lamivudine; group 2 ( n = 10), lamivudine plus tenofovir and group 3 ( n = 20), lamivudine followed by lamivudine plus tenofovir. HBV genotypes and resistance profiles were determined by the Bayer Trugene® HBV 1.0 assay. More patients in group 2 achieved HBV DNA suppression below 2000 copies/mL (80%), loss of HBe antigen (HBeAg) (40%) and loss of HBeAg and gain of anti‐HBe (20%) than did patients in group 1 or 3. More patients with HBV genotype A, achieved HBV DNA suppression <2000 copies/mL than did patients with non‐A genotypes [74% (26/35) vs 20% (2/10)], respectively ( P = 0.003). Risk for virological nonresponse was significant in those with non‐A genotypes [odds ratio (OR) 11.1; 95% CI: 2.0–50], previous HIV therapy (OR 6.5; 95% CI: 1.2–35) and <90% compliance (OR 3.7; 95% CI: 0.99–14.3). Simultaneous therapy with lamivudine/tenofovir suppresses HBV DNA more effectively than lamivudine or tenofovir added to lamivudine. More patients infected with HBV genotype A responded than the non‐A patients, regardless of therapeutic regimen, compliance or prior HIV therapy.