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

Abstract

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 log(10)), 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.

• Authors: Christoph Stephan, Annemarie Berger, Amina Carlebach, Thomas Lutz, Markus Bickel, Stephan Klauke, Schlomo Staszewski, Martin Stuermer
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 56 Issue 6 Pg. 1087-93 (Dec 2005) ISSN: 0305-7453 [Print] England
• PMID: 16269552 (Publication Type: Journal Article)

Chemical References

• Anti-HIV Agents
• DNA, Viral
• Hepatitis B Surface Antigens
• Hepatitis B e Antigens
• Organophosphonates
• Tenofovir
• Adenine

Topics

• Adenine (administration & dosage, analogs & derivatives, pharmacology, therapeutic use)
• Adult
• Aged
• Anti-HIV Agents (administration & dosage, pharmacology, therapeutic use)
• Antiretroviral Therapy, Highly Active
• Cohort Studies
• DNA, Viral (chemistry, genetics)
• Drug Resistance, Viral (genetics)
• Evolution, Molecular
• Female
• Genes, pol
• HIV Infections (complications, drug therapy)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B e Antigens (blood)
• Hepatitis B virus (drug effects, genetics, physiology)
• Hepatitis B, Chronic (complications, drug therapy, virology)
• Humans
• Male
• Middle Aged
• Organophosphonates (administration & dosage, pharmacology, therapeutic use)
• Tenofovir
• Viral Load
• Viremia
• Virus Replication (drug effects)