Long-term therapy with tenofovir is effective for patients co-infected with human immunodeficiency virus and hepatitis B virus.

[Guest guest]

Gastroenterology. 2010 Dec;139(6):1934-41. Epub 2010 Aug 26.

Long-term therapy with tenofovir is effective for patients co-infected with

human immunodeficiency virus and hepatitis B virus.

de Vries-Sluijs TE, Reijnders JG, Hansen BE, Zaaijer HL, Prins JM, Pas SD,

Schutten M, Hoepelman AI, Richter C, Mulder JW, de Man RA, Janssen HL, van der

Ende ME.

Department of Internal Medicine-Infectious Diseases, Erasmus MC University

Medical Center, Rotterdam, The Netherlands. t.sluijs@...

Comment in:

Gastroenterology. 2010 Dec;139(6):1827-9.

Abstract

BACKGROUND & AIMS: We investigated the long-term efficacy and renal safety of

tenofovir disoproxil fumarate (TDF), administered to patients co-infected with

human immunodeficiency virus and hepatitis B virus (HBV) as part of an

antiretroviral therapy.

METHODS: We performed a multicenter, prospective cohort study of 102 patients

co-infected with human immunodeficiency virus and HBV who were treated with TDF.

RESULTS: At baseline, 80% of patients had a detectable viral load (HBV DNA >20

IU/mL). Among patients positive for hepatitis B e antigen (HBeAg) (n = 67), 92%

had a virologic response (HBV DNA <20 IU/mL) after 5 years of treatment. There

was no difference between patients with or without lamivudine resistance at

baseline (P = .39). Loss rates of HBeAg and hepatitis B s antigen (HBsAg) were

46% and 12%, respectively. Among HBeAg-negative patients (n = 15), 100% had a

virologic response after 4 years of treatment and 2 (13%) lost HBsAg. Twenty

subjects (20%, all HBeAg-negative) had undetectable HBV DNA at baseline; during

a median follow-up period of 52 months (interquartile range, 41-63 mo), 19 (95%)

maintained a virologic response and 2 (10%) lost HBsAg. Overall, one patient

acquired a combination of resistance mutations for anti-HBV drugs and

experienced a virologic breakthrough. Three (3%) patients discontinued TDF

because of increased serum creatinine levels. The estimated decrease in renal

function after 5 years of TDF therapy was 9.8 mL/min/1.73 m(2), which was most

pronounced shortly after TDF therapy was initiated.

CONCLUSIONS: TDF, administered as part of antiretroviral therapy, is a potent

anti-HBV agent with a good resistance profile throughout 5 years of therapy.

Only small nonprogressive decreases in renal function were observed.

AGA Institute. Published by Elsevier Inc. All rights reserved.

PMID: 20801123 [PubMed - indexed for MEDLINE]