The anti-HIV activity of entecavir: a multicentre evaluation of lamivudine-experienced and lamivudine-naive patients

Joe Sasadeusz, Jennifer M Audsley, Anne M Mijch, Rachel Baden, Jose Caro, Hermeyone Hunter, Gail Matthews, Moira A McMahon, Susan A Olender, Robert F Siliciano, Sharon R Lewin, Chloe Thio

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41 Citations (Scopus)


BACKGROUND: Entecavir, an antiviral with potent anti-hepatitis B virus activity, was recently shown to have anti-HIV activity in three patients and the ability to select for the lamivudine-resistant HIV polymerase mutation M184V in a patient with prior antiretroviral therapy. OBJECTIVES: To further characterize entecavir s anti-HIV activity and identify risk factors for selection of the M184V. DESIGN: Retrospective cohort study. METHODS: We evaluated the virological characteristics of HIV and hepatitis B virus in 17 HIV-hepatitis B virus coinfected patients (10 antiretroviral therapy-naive and seven antiretroviral therapy-experienced) prior to and during entecavir monotherapy. Descriptive statistics were used to assess changes in HIV RNA and hepatitis B virus DNA. Variables associated with development of the M184V were determined by univariate analysis. RESULTS: Of the 17 patients, 13 (76 ) demonstrated a reduction in HIV RNA by at least 0.5 log10 copies/ml. Of the remaining four patients, two had the M184V detected prior to entecavir therapy and the other two had wild-type HIV. The median reduction in HIV RNA for the cohort was 1.2 log10 copies/ml, which was similar in antiretroviral therapy-naive and antiretroviral therapy-experienced patients. The M184V mutation emerged in six patients receiving entecavir, including three antiretroviral therapy-naive patients. No other HIV mutations were consistently detected. Risk factors for the emergence of the M184V mutation were a decline in hepatitis B virus DNA (P = 0.04) and duration of entecavir use (P = 0.05). CONCLUSION: Entecavir monotherapy in HIV-hepatitis B virus coinfected patients, including antiretroviral therapy-naive patients, has significant anti-HIV activity and can result in the development of the M184V variant. Entecavir should not be used in such co-infected patients without concomitant antiretroviral therapy.
Original languageEnglish
Pages (from-to)947 - 955
Number of pages9
Issue number8
Publication statusPublished - 2008

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