Antiretroviral Therapy is Well-tolerated and Rapidly Suppresses HBV Viral Load
in HIV-HBV Coinfected Patients
to overlapping transmission routes, many HIV
positive people have also been exposed to hepatitis
B virus (HBV), and an estimated 10% have chronic
the 44th Annual Meeting of the European Association for
the Study of the Liver (EASL 2009) last month in Copenhagen, Austrian researchers
presented data from a study of highly
active antiretroviral therapy (HAART) in coinfected patients, showing that
HIV-HBV coinfected people tolerate HAART well and achieve outcomes as good as
those of HIV negative people with hepatitis B alone.
antiretroviral drugs often used to treat HIV -- lamivudine
(3TC; Epivir), emtricitabine
(FTC; Emtriva), and tenofovir
(Viread, also in the Truvada
and Atripla combination pills)
-- are also active against HBV
Treatment guidelines recommend that HIV-HBV coinfected individuals should
include these drugs in their regimen.
present retrospective analysis included 100 HIV-HBV coinfected participants treated
at the HIV outpatient clinic at the Medical University of Vienna between 1998
and 2008. About two-thirds (64%) were hepatitis B "e" antigen (HBeAg)
positive. Most (82%) were receiving HAART, with 63% taking tenofovir, 46% taking
lamivudine, and 31% taking emtricitabine.
Before starting HAART, the mean HBV DNA level was about 4,500,000,000 IU/mL.
HBeAg positive patients had a significantly higher average HBV viral load than
HBeAg negative individuals (about 7,500,000,000 vs about 2,00,000,000 IU/mL, respectively).
Over a median observation period of 68 month (range 2-171), 73% of study participants
achieved complete HBV DNA suppression (lower limit of detection 351 IU/mL).
Overall, 63% patients experienced HBeAg seroconversion, for an annual probability
The cumulative annual rate of hepatitis B surface-antigen (HBsAg) loss was 6.6%
among HBeAg positive patients and 8.7% among HBeAg negative patients.
12% of participants experienced transient aminotransferases (ALT or AST) elevations
after starting HAART.
However, there were no instances of serious (grade 3 or 4) liver toxicity.
treatment in HBV-HIV coinfected patients is well tolerated and leads to rapid
suppression of HBV replication despite high baseline viremia," the investigators
concluded. "Rates of HBeAg seroconversion and HBsAg loss in HBV-HIV coinfected
patients are comparable to or even higher than in HBV mono-infected patients."
& Hepatology, Dermatology, Division of Infectious Diseases, Medical University
of Vienna, Vienna, Austria.
Kosi, T Reiberger, K Rutter, and others.Efficacy of highly active anti-retroviral
therapy (HAART) in patients with HBV-HIV co-infection. 44th Annual Meeting of
the European Association for the Study of the Liver (EASL 2009). Copenhagen, Denmark.
April 22-26, 2009.
2009 MAIN PAGE
Conference on Retroviruses and Opportunistic Infections (CROI 2009)
by HIV and Hepatitis.com - February 8 - 11, 2009, Montreal
HIV and AIDS Treatment
News, Experimental News, FDA-approved News
of the 15th Conference on Retroviruses and Opportunistic Infections (CROI 2009)
- Coverage by HIV and Hepatitis.com, February 8 - 11, 2009, Montreal