Tenofovir Leads to HBsAg Clearance in 8% of HIV/HBV Coinfected Patients

Treatment with tenofovir (Viread) led to hepatitis B surface antigen (HBsAg) clearance -- considered the closest outcome to a cure -- in 8% of HIV positive patients with chronic hepatitis B virus (HBV) coinfection, and in a subgroup clearance was associated with CD4 T-cell count, Dutch researchers reported in the September 15, 2012, Journal of Infectious Diseases.alt

People with HIV/HBV coinfection tend to experience more aggressive liver disease progression and may not respond as well to hepatitis B treatment as patients with HBV alone. Some anti-HIV drugs, including tenofovir (also in the Atripla, Complera, and Stribild coformulations), are also active against HBV, and current antiretroviral treatment guidelines recommend that coinfected individuals should include at least 1 dually active agent in their regimen.

Roeland Zoutendijk from Erasmus MC University Medical Center in Rotterdam and colleagues analyzed serum HBsAg levels in a Dutch multicenter cohort of 104 HIV/HBV coinfected patients who were treated with tenofovir disoproxil fumarate as part of combination antiretroviral therapy. Participants had been HBsAg positive for at least 6 months and the median duration of treatment was 57 months.


"Receipt of [tenofovir] therapy by HIV/HBV coinfected patients for up to 6 years led to a significant decrease in HBsAg in the HBeAg positive population," the researchers concluded.

"HBsAg kinetics early during treatment were predictive of HBsAg seroclearance and correlated with an increased CD4 cell count, underlining the importance of immune restoration in HBV clearance," they added.  

"Clearance of hepatitis B virus in these coinfected patients could be of vital importance for their long-term prognosis," they wrote.



R Zoutendijk, HL Zaaijer, T.E.M.S. de Vries-Sluijs, et al. Hepatitis B Surface Antigen Declines and Clearance During Long-Term Tenofovir Therapy in Patients Coinfected With HBV and HIV. Journal of Infectious Diseases 206(6):974-980. September 15, 2012.