Long-term outcome of primary non-responders to tenofovir therapy in HIV/HBV-co-infected patients: impact of HBV genotype G

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02601.x/abstract

Long-term outcome of primary non-responders to tenofovir therapy in

HIV/HBV-co-infected patients: impact of HBV genotype G

Olivier Lada1, Anne Gervais2, Michel Branger3, Gilles Peytavin4, Benedicte

Roquebert3, Gilles Collin3, Gil Fraqueiro2, Rami Moucari1, Gwen Hamet2,

ot-Peignoux1, Sophie Matheron2, Marcellin1Article first published

online: 9 AUG 2011

DOI: 10.1111/j.1478-3231.2011.02601.x

© 2011 Wiley & Sons A/S

Issue

Liver International

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

Abstract

Aim

To evaluate the early virological response (EVR) to combined

tenofovir-lamivudine or emtricitabine regimen in HBV/HIV-co-infected patients

and the long-term efficacy of tenofovir.

Methods

In this retrospective monocentric study, among the 166 HIV/HBV-co-infected

patients regularly followed from 2003 to 2008 at Bichat Claude Bernard Hospital,

61 patients had received, either de novo combination therapy with tenofovir and

lamivudine or emtricitabine (group I, n = 15) or add-on tenofovir to lamivudine

therapy (group II, n = 46). The HBV polymerase region was sequenced and analysed

for all patients with available samples.

Results

All 15 group I patients achieved EVR vs 32 (82%) of group II patients (P =

0.15). Seven adherent group II patients met criteria for primary non-response,

but achieved delayed response (DR) to therapy. In these seven patients, when

compared with the 39 group II patients, there was a trend to longer duration of

lamivudine pre-treatment and to higher rate of lamivudine-resistant mutants; and

HBV genotype-G proportion was higher (P = 0.026). No virological breakthrough

occurred after a median of 46 months follow up.

Conclusion

In these HBV/HIV-co-infected patients, first-line HBV therapy with tenofovir and

emtricitabine or lamivudine was associated with EVR. However, DR to tenofovir

was observed in 15% of patients who added tenofovir to lamivudine therapy, of

whom four of seven (57%) had genotype G-HBV infection. No resistance was

evidenced after 46 months of therapy even in patients with DR to tenofovir. At

last, a good renal safety profile of TDF was observed after a median follow-up

of 4 years of therapy.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02601.x/abstract

Long-term outcome of primary non-responders to tenofovir therapy in

HIV/HBV-co-infected patients: impact of HBV genotype G

Olivier Lada1, Anne Gervais2, Michel Branger3, Gilles Peytavin4, Benedicte

Roquebert3, Gilles Collin3, Gil Fraqueiro2, Rami Moucari1, Gwen Hamet2,

ot-Peignoux1, Sophie Matheron2, Marcellin1Article first published

online: 9 AUG 2011

DOI: 10.1111/j.1478-3231.2011.02601.x

© 2011 Wiley & Sons A/S

Issue

Liver International

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

Abstract

Aim

To evaluate the early virological response (EVR) to combined

tenofovir-lamivudine or emtricitabine regimen in HBV/HIV-co-infected patients

and the long-term efficacy of tenofovir.

Methods

In this retrospective monocentric study, among the 166 HIV/HBV-co-infected

patients regularly followed from 2003 to 2008 at Bichat Claude Bernard Hospital,

61 patients had received, either de novo combination therapy with tenofovir and

lamivudine or emtricitabine (group I, n = 15) or add-on tenofovir to lamivudine

therapy (group II, n = 46). The HBV polymerase region was sequenced and analysed

for all patients with available samples.

Results

All 15 group I patients achieved EVR vs 32 (82%) of group II patients (P =

0.15). Seven adherent group II patients met criteria for primary non-response,

but achieved delayed response (DR) to therapy. In these seven patients, when

compared with the 39 group II patients, there was a trend to longer duration of

lamivudine pre-treatment and to higher rate of lamivudine-resistant mutants; and

HBV genotype-G proportion was higher (P = 0.026). No virological breakthrough

occurred after a median of 46 months follow up.

Conclusion

In these HBV/HIV-co-infected patients, first-line HBV therapy with tenofovir and

emtricitabine or lamivudine was associated with EVR. However, DR to tenofovir

was observed in 15% of patients who added tenofovir to lamivudine therapy, of

whom four of seven (57%) had genotype G-HBV infection. No resistance was

evidenced after 46 months of therapy even in patients with DR to tenofovir. At

last, a good renal safety profile of TDF was observed after a median follow-up

of 4 years of therapy.