title: [Emergence of resistant hepatitis B virus strains during long-term lamivudine therapy in human immunodeficiency virus co-infected patients].
abstract: Seven patients co-infected with hepatitis B virus (HBsAg and HBeAg carriers, quantifiable HBV DNA with the bDNA technic) and human immunodeficiency virus received a triple antiretroviral combination therapy, including lamivudine (150 mg twice a day). Hepatitis B viral load rapidly became undetectable in 6/7 patients. It remained below the level of detection in 2 subjects, after 20 and 22 months of treatment, with one of them achieving HBeAg/anti-HBe seroconversion. However, in the other 4 individuals, hepatitis B viremia increased again after 8 to 16 months of lamivudine-containing regimen. The last patient was a non-responder. The 4 relapsers developed a double mutation Leu(528) for Met(528) and Met(552) for Val(552), on hepatitis B virus polymerase, either concomitant (M8 and M16) with a hepatitis B virus DNA increase, or 2 months earlier (M10 and M12). The high frequency of hepatitis B virus resistance to lamivudine emphasizes the necessity of identifying more effective strategies, such as double combination therapies.
authors.affiliation: Centre d'Informations et de Soins de l'Immunodéficience Humaine, Clinique Médicale A, Hôpitaux Universitaires, Strasbourg.
authors.forename: D
authors.initials: D
authors.lastname: Rey
authors.forename: S
authors.initials: S
authors.lastname: Fritsch
authors.forename: C
authors.initials: C
authors.lastname: Schmitt
authors.forename: M
authors.initials: M
authors.lastname: Partisani
authors.forename: G
authors.initials: G
authors.lastname: Kempf-Durepaire
authors.forename: M
authors.initials: M
authors.lastname: Nicolle
authors.forename: V
authors.initials: V
authors.lastname: Krantz
authors.forename: E
authors.initials: E
authors.lastname: De Mautort
authors.forename: F
authors.initials: F
authors.lastname: Stoll-Keller
authors.forename: J M
authors.initials: JM
authors.lastname: Lang
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006509:Hepatitis B / Q000150:complications* / Q000821:virology*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D019259:Lamivudine