Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV-coinfected patients: Factors associated with response

M. K. Jain, L. Comanor, C. White, P. Kipnis, C. Elkin, K. Leung, A. Ocampo, N. Attar, P. Keiser, W. M. Lee

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)176-182
Number of pages7
JournalJournal of viral hepatitis
Volume14
Issue number3
DOIs
StatePublished - Mar 1 2007
Externally publishedYes

    Fingerprint

Keywords

  • HBV genotype
  • HIV/HBV coinfection
  • Lamivudine
  • Tenofovir
  • Therapeutic response

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases
  • Virology

Cite this