CROI 2012: Long-term Tenofovir Promotes HBsAg Decline in HIV/HBV Coinfected People


Hepatitis B surface antigen (HBsAg) levels declined steadily in HIV/HBV coinfected patients treated with tenofovir for up to 8 years, especially those with rising CD4 T-cell counts, researchers reported at the 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012) this month in Seattle.

HIV positive people coinfected with hepatitis B virus (HBV) tend to experience more severe liver disease progression than individuals with hepatitis B alone. Tenofovir (Viread, also in the Truvada and Atripla coformulations) -- which is active against both HIV and HBV -- has been shown to reduce HBV viral load in coinfected people, but its effect on HBsAg levels in this population has been less extensively studied. HBsAg clearance, generally considered a cure, is uncommon.

Theodora de Vries-Sluijs from Erasmus Medical Center in Rotterdamand colleagues measured HBsAg changes in 104 HIV/HBV coinfected patients who received ART regimens containing tenofovir for at least 6 months.

Most participants (about 90%) were men, about 60% were white, and the average age was bout 42 years. They had been HBsAg positive -- indicating current HBV infection -- for at least 6 months. Two-thirds were hepatitis B "e" antigen (HBeAg) positive at baseline and 63% had HBV genotype A. The researchers measured HBsAg levels at baseline, at 6 months, and then annually, with a median follow-up duration of 56 months.


"[Tenofovir] for HIV/HBV [coinfected] patients up to 6 years leads to significant HBsAg decline in the HBeAg positive population," the researchers concluded. "Early HBsAg kinetics were predictive for HBsAg seroclearance in HBeAg positive patients and correlated with [increased] CD4 cell count."

These findings, they suggested, "underline the importance of immune restoration in HBV clearance.



Tde Vries-Sluijs, R Zoutendijk, H Zaaijer, et al. TDF Treatment for Up To Eight Years Results in Pronounced HBsAg Decline in HBeAg positive HIV/HBV Coinfected Patients. 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012). Seattle, WA. March 5-8, 2012. Abstract 53