HIV
and Hepatitis.com Coverage of the 14th
Annual Conference on Retroviruses and Opportunistic Infections (14th CROI) February
25 - 28, 2007, Los Angeles, CA
Long-term
Lamivudine plus Tenofovir Is Safe and Effective for HIV-HBV Coinfected Patients
While
several studies have demonstrated good results after a follow-up period of 12
months, little is known about the long-term safety and efficacy of lamivudine
plus tenofovir in HIV-HBV coinfected patients.
As reported at the 14th
Conference on Retroviruses and Opportunistic Infections last month in Los
Angeles, researchers from the Netherlands identified 44 HIV-HBV coinfected patients
treated with lamivudine plus tenofovir for at least 6 months during 2002-2006.
The investigators collected data on patient characteristics, date of tenofovir
initiation, and CD4 cell count;
they also performed virological assessments at baseline (i.e., time of tenofovir
initiation) and on stored serum. Most patients (39) were men and the median age
was 38 years. At baseline, 23 subjects had undetectable HIV RNA and the median
CD4 cell count was 255 cells/mm3.
Results
•
63.6% of participants
had used lamivudine, for a median duration of 49 months.
•
10 of these subjects
had HBV DNA < 1000 copies/mL at the time of tenofovir initiation.
•
In 15 of the 18 remaining
lamivudine-experienced patients, YMDD mutations were sequenced at baseline.
•
At baseline, HBeAg
was positive in 29 of 44 patients (65.9%) and the median HBV DNA level was 8.94
log10.
•
The median time of
observed lamivudine plus tenofovir use was 36 months.
•
The proportions of
patients with HBV DNA < 1000 copies/mL increased from 27% at baseline to 86%
by Month 36.
•
The median decrease
in HBV DNA after 36 months was 4.8 log10.
•
57% of patients experienced
HBeAg loss.
•
A univariate analysis
did not find any predictive factors associated with achievement of undetectable
HBV DNA.
Conclusion
The researchers concluded that antiviral treatment of hepatitis B
using a combination of lamivudine plus tenofovir was "safe and persistently
effective" in HIV-HBV coinfected patients with wild type, precore-mutant,
and lamivudine-resistant HBV.
Reference TEMS
de Vries-Sluijs, R de Man, M Schutten, and others. Long-term Efficacy of Combination
Lamivudine + Tenofovir Therapy in Chronic HIV/HBV-co-infected Patients. 14th Conference
on Retroviruses and Opportunistic Infections; February 25-28, 2007; Los Angeles,
California. Abstract 939 (poster).
