Patterns and causes of suboptimal response to tenofovir-based therapy in individuals coinfected with HIV and hepatitis B virus

Gail Matthews, Eric C Seaberg, Anchalee Avihingsanon, Scott Bowden, Gregory J Dore, Sharon R Lewin, Joe Sasadeusz, Peter Revill, Margaret Littlejohn, Jennifer F Hoy, Robert Finlayson, Kiat Ruxrungtham, Melissa Saulynas, Stephen Locarnini, Chloe L Thio

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Background. Tenofovir (TDF) is effective for treatment of hepatitis B virus (HBV) in human immunodeficiency virus (HIV) infection; however, some individuals have ongoing HBV viremia, the reasons for which are unclear. We determined the patterns and factors associated with detectable HBV DNA in HIV-HBV-coinfected subjects on highly active antiretroviral therapy (HAART).Methods. One hundred sixty-five HIV-HBV-coinfected individuals from the United States, Australia, and Thailand, the majority of whom were on HAART at study entry, were prospectively followed semiannually for a median of 2.8 years. Logistic regression was used to determine factors associated with detectable HBV DNA.Results. Anti-HBV regimens were TDF/emtricitabine (57 ), lamivudine or emtricitabine (19 ), or TDF monotherapy (13 ). During follow-up, HBV DNA was detected at 21 of study visits and was independently associated with hepatitis B e antigen (HBeAg), HAART 1 log from nadir), and viral blips. No TDF resistance was identified.Conclusions. Tenofovir/ emtricitabine was superior to other anti-HBV regimens in long-term HBV suppression. HBV viremia on therapy was identified in 1 of 3 main patterns. Suboptimal adherence was associated with detectable HBV DNA during therapy, even when HIV was undetectable. ? 2012 The Author
Original languageEnglish
Pages (from-to)87 - 94
Number of pages8
JournalClinical Infectious Diseases
Issue number9
Publication statusPublished - 2013

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