HBV lamivudine resistance among hepatitis B and HIV coinfected patients starting lamivudine, stavudine and nevirapine in Kenya

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01466.x/abstract

HBV lamivudine resistance among hepatitis B and HIV coinfected patients starting

lamivudine, stavudine and nevirapine in Kenya

H. N. Kim1, J. 1, A. Cent2, L. Cook2,3, R. A. Morrow2, B. 4, K.

Tapia5, K. R. Jerome2,3, G. Lule6, G. -1,5, M. H. Chung1,5,6Article

first published online: 13 MAY 2011

DOI: 10.1111/j.1365-2893.2011.01466.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Online Version of Record published before inclusion in an issue)

Summary.  Widespread use of lamivudine in antiretroviral therapy may lead to

hepatitis B virus resistance in HIV–HBV coinfected patients from endemic

settings where tenofovir is not readily available. We evaluated 389 Kenyan

HIV-infected adults before and for 18 months after starting highly active

antiretroviral therapy with stavudine, lamivudine and nevirapine. Twenty-seven

(6.9%) were HBsAg positive and anti-HBs negative, 24 were HBeAg negative, and 18

had HBV DNA levels ≤10 000 IU/mL. Sustained HBV suppression to <100 IU/mL

occurred in 89% of 19 evaluable patients. Resistance occurred in only two

subjects, both with high baseline HBV DNA levels. Lamivudine resistance can

emerge in the setting of incomplete HBV suppression but was infrequently

observed among HIV–HBV coinfected patients with low baseline HBV DNA levels.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01466.x/abstract

HBV lamivudine resistance among hepatitis B and HIV coinfected patients starting

lamivudine, stavudine and nevirapine in Kenya

H. N. Kim1, J. 1, A. Cent2, L. Cook2,3, R. A. Morrow2, B. 4, K.

Tapia5, K. R. Jerome2,3, G. Lule6, G. -1,5, M. H. Chung1,5,6Article

first published online: 13 MAY 2011

DOI: 10.1111/j.1365-2893.2011.01466.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Online Version of Record published before inclusion in an issue)

Summary.  Widespread use of lamivudine in antiretroviral therapy may lead to

hepatitis B virus resistance in HIV–HBV coinfected patients from endemic

settings where tenofovir is not readily available. We evaluated 389 Kenyan

HIV-infected adults before and for 18 months after starting highly active

antiretroviral therapy with stavudine, lamivudine and nevirapine. Twenty-seven

(6.9%) were HBsAg positive and anti-HBs negative, 24 were HBeAg negative, and 18

had HBV DNA levels ≤10 000 IU/mL. Sustained HBV suppression to <100 IU/mL

occurred in 89% of 19 evaluable patients. Resistance occurred in only two

subjects, both with high baseline HBV DNA levels. Lamivudine resistance can

emerge in the setting of incomplete HBV suppression but was infrequently

observed among HIV–HBV coinfected patients with low baseline HBV DNA levels.