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Long‐term outcome of primary non‐responders to tenofovir therapy in HIV / HBV ‐co‐infected patients: impact of HBV genotype G
Author(s) -
Lada Olivier,
Gervais Anne,
Branger Michel,
Peytavin Gilles,
Roquebert Benedicte,
Collin Gilles,
Fraqueiro Gil,
Moucari Rami,
Hamet Gwen,
MartinotPeignoux Michelle,
Matheron Sophie,
Marcellin Patrick
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02601.x
Subject(s) - emtricitabine , lamivudine , medicine , gastroenterology , regimen , tenofovir , virology , hepatitis b virus , human immunodeficiency virus (hiv) , virus
Aim To evaluate the early virological response ( EVR ) to combined tenofovir‐lamivudine or emtricitabine regimen in HBV / HIV ‐co‐infected patients and the long‐term efficacy of tenofovir. Methods In this retrospective monocentric study, among the 166 HIV / HBV ‐co‐infected patients regularly followed from 2003 to 2008 at Bichat Claude Bernard Hospital, 61 patients had received, either de novo combination therapy with tenofovir and lamivudine or emtricitabine (group I, n = 15) or add‐on tenofovir to lamivudine therapy (group II, n = 46). The HBV polymerase region was sequenced and analysed for all patients with available samples. Results All 15 group I patients achieved EVR vs 32 (82%) of group II patients ( P = 0.15). Seven adherent group II patients met criteria for primary non‐response, but achieved delayed response ( DR ) to therapy. In these seven patients, when compared with the 39 group II patients, there was a trend to longer duration of lamivudine pre‐treatment and to higher rate of lamivudine‐resistant mutants; and HBV genotype‐G proportion was higher ( P = 0.026). No virological breakthrough occurred after a median of 46 months follow up. Conclusion In these HBV / HIV ‐co‐infected patients, first‐line HBV therapy with tenofovir and emtricitabine or lamivudine was associated with EVR . However, DR to tenofovir was observed in 15% of patients who added tenofovir to lamivudine therapy, of whom four of seven (57%) had genotype G‐ HBV infection. No resistance was evidenced after 46 months of therapy even in patients with DR to tenofovir. At last, a good renal safety profile of TDF was observed after a median follow‐up of 4 years of therapy.