A case of HIV co-infected with hepatitis B virus precore/core deletion mutant treated by entecavir.
We report a case of a HIV and hepatitis B virus (HBV)-co-infected patient to whom entecavir (ETV) was administered initially before the notification regarding the potential mutagenesis effect on HIV against the nucleoside analog. Since initial evaluations indicated the advanced stage of chronic hepatitis B and preserved numbers of peripheral CD4+ lymphocytes without the manifestation of immunodeficiency, priority was given to the management of HBV. We started HBV therapy with ETV at a dose of 0.5 mg daily without using any HIV drugs. The viral loads of both HBV and HIV-1 decreased gradually during the 5 months following the initial administration of ETV. HBV was well controlled by the gradual replacement of ETV with highly-active antiretroviral therapy against HIV with a regimen including atazanavir, emtricitabine, and tenofovir. HBV was genotyped as A2 with the quasispecies pool consisting of the -1G precore/core deletion mutant strain.
Fukushima
Koji
K
Department of Internal Medicine, Tohoku University Hospital, Sendai, Japan.
Ueno
Yoshiyuki
Y
Inoue
Jun
J
Wakui
Yuta
Y
Obara
Noriyuki
N
Kimura
Osamu
O
Kido
Osamu
O
Nakagome
Yu
Y
Kakazu
Eiji
E
Matsuda
Yasunori
Y
Kogure
Takayuki
T
Kondo
Yasuteru
Y
Nagasaki
Futoshi
F
Yamagiwa
Yoko
Y
Ashino
Yugo
Y
Shimosegawa
Tooru
T