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HBV lamivudine resistance among hepatitis B and HIV coinfected patients starting lamivudine, stavudine and nevirapine in Kenya
Author(s) -
Kim H. N.,
Scott J.,
Cent A.,
Cook L.,
Morrow R. A.,
Richardson B.,
Tapia K.,
Jerome K. R.,
Lule G.,
JohnStewart G.,
Chung M. H.
Publication year - 2011
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.1365-2893.2011.01466.x
Subject(s) - lamivudine , stavudine , nevirapine , hbsag , medicine , virology , hepatitis b virus , hepatitis b , hbeag , human immunodeficiency virus (hiv) , viral load , antiretroviral therapy , virus
Summary. Widespread use of lamivudine in antiretroviral therapy may lead to hepatitis B virus resistance in HIV–HBV coinfected patients from endemic settings where tenofovir is not readily available. We evaluated 389 Kenyan HIV‐infected adults before and for 18 months after starting highly active antiretroviral therapy with stavudine, lamivudine and nevirapine. Twenty‐seven (6.9%) were HBsAg positive and anti‐HBs negative, 24 were HBeAg negative, and 18 had HBV DNA levels ≤10 000 IU/mL. Sustained HBV suppression to <100 IU/mL occurred in 89% of 19 evaluable patients. Resistance occurred in only two subjects, both with high baseline HBV DNA levels. Lamivudine resistance can emerge in the setting of incomplete HBV suppression but was infrequently observed among HIV–HBV coinfected patients with low baseline HBV DNA levels.