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Long‐term outcome of tenofovir disoproxil fumarate use against hepatitis B in an HIV‐coinfected cohort
Author(s) -
AlvarezUria G,
Ratcliffe L,
Vilar JF
Publication year - 2009
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2008.00683.x
Subject(s) - lamivudine , medicine , emtricitabine , hbeag , hepatitis b , hepatitis b virus , gastroenterology , tenofovir , cohort , virology , coinfection , hbsag , human immunodeficiency virus (hiv) , virus
Objectives Tenofovir disoproxil fumarate (TDF) is active against hepatitis B virus (HBV) and HIV. However, the long‐term efficacy of tenofovir disoproxil fumarate (TDF) is not well known and the appearance of resistance is a major concern. We have studied the efficacy of TDF against HBV in patients treated at an Infectious Diseases Unit. Methods We carried out a retrospective observational study of the efficacy of TDF against HBV replication in a cohort of 52 HIV‐coinfected patients who received TDF for at least 6 months. Results The median duration of follow‐up of TDF treatment was 34 months. Forty‐one patients (79%) were positive for HBV envelope antigen (HBeAg) and 35 had received previous lamivudine monotherapy for a median duration of 32 months. Virological breakthrough was observed in nine cases (17%). At the end of the follow‐up period, HBV DNA levels were <1000 copies/mL in 42 patients (81%) and <200 copies/mL in 31 patients (60%). There were no significant differences between the lamivudine‐naïve and lamivudine‐experienced groups. In the lamivudine‐experienced group, the duration of previous lamivudine monotherapy was associated with failure to achieve HBV DNA levels <200 copies/mL ( P =0.036). Adding lamivudine or emtricitabine to TDF did not improve virological suppression. In 39 patients who achieved <200 HBV DNA copies/mL during TDF treatment, virological breakthrough was seen only in two patients (5%) after a median follow‐up duration of 39.7 months. Conclusions TDF was able to control HBV replication in most HIV‐coinfected patients after a median follow‐up duration of 34 months, regardless of previous lamivudine treatment. However, a sizeable proportion of patients developed virological breakthrough.