Comparison of the antiviral activity of adefovir and tenofovir on hepatitis B virus in HIV-HBV-coinfected patients

September 16, 2008

Antivir Ther. 2008;13(5):705-13.

Comparison of the antiviral activity of adefovir and tenofovir on hepatitis B

virus in HIV-HBV-coinfected patients.

Lacombe K, Gozlan J, Boyd A, Boelle PY, Bonnard P, Molina JM, Miailhes P,

Lascoux-Combe C, Serfaty L, Zoulim F, Girard PM.

INSERM UMR-S707, Paris, France. karine.lacombe@...

BACKGROUND: Characteristics and factors influencing viral decay under tenofovir

(TDF) and adefovir (ADV) need to be determined in HIV-HBV-coinfected patients.

METHODS: This open-label study compared the HBV dynamics in 85

HIV-HBV-coinfected patients initiating an antiretroviral regimen, either

including TDF or associated with ADV. The first 6-month change in viral load was

analysed using mixed linear models. The adjusted hazards ratio, comparing the

rates of undetectable HBV DNA between treatments, was calculated using a

proportional hazard model. RESULTS: The HBV DNA decay, adjusted for baseline HBV

viral load was more pronounced in patients treated with TDF than with ADV at 12

months (66% versus 53%, P=0.0001). Patients in the TDF group presented a steeper

slope of decline at 1.1 (95% confidence interval [CI] 0.9-1.3), compared with

0.8 (95% CI 0.6-1.0) in the ADV group (P=0.036). The mean time to HBV DNA

undetectability was 19.3 months (95% CI 16.7-22.0) with TDF and 25.9 months (95%

CI 21.1-30.7) with ADV. When adjusted for hepatitis B virus e antigen, HBV DNA

and alanine aminotransferase levels at baseline, the influence of treatment on

time to HBV DNA undetectability remained in favour of TDF versus ADV (hazard

ratio=2.79, 95% CI 1.05-7.40, P=0.039) CONCLUSIONS: TDF influenced more strongly

the early-phase HBV DNA kinetics than ADV. This is associated with a sustained

antiviral activity in the TDF group, in which patients reached the threshold of

HBV undetectability at a faster rate and in a larger proportion than those

taking ADV.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 18771054 [PubMed - in process]

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