title: Combination HBV therapy is linked to greater HBV DNA suppression in a cohort of lamivudine-experienced HIV/HBV coinfected individuals.
abstract: OBJECTIVE
  To determine if highly active antiretroviral therapy (HAART) with combination anti-hepatitis B virus (HBV) therapy compared to HAART with HBV monotherapy leads to greater HBV DNA suppression in an HIV/HBV coinfected cohort.
  
  
  METHODS
  A cross-sectional analysis of 122 HIV/HBV coinfected patients from Australia and the United States.
  
  
  METHODS
  Univariate analysis and ordinal logistic regression were used to determine factors associated with an HBV DNA less than 100 IU/ml.
  
  
  RESULTS
  The majority of patients were on HAART (85%), had an HIV RNA less than 50 copies/ml, a median CD4 cell count of 438 cells/microl, and had prior or current lamivudine therapy (98%). The majority (89%) of those on HAART were on HBV-active drugs including 54% on tenofovir (TDF) with either lamivudine (LAM) or emtrictabine (FTC), 34% receiving LAM or FTC monotherapy, and 12% on TDF monotherapy. Only 4% of patients in the combination (TDF + LAM/FTC) group had HBV DNA greater than 20 000 IU/ml compared to 54% in the group on no HBV-active therapy, 31% in the LAM or FTC monotherapy group, and 30% in the TDF monotherapy group (P < 0.0001). In an ordinal logistic regression model, monotherapy with either TDF or LAM remained independently associated with higher HBV DNA.
  
  
  CONCLUSIONS
  These data suggest that there may be an advantage to using TDF in combination with LAM or FTC in HIV/HBV coinfection, particularly in the setting of previous LAM experience. Continued prospective follow-up in this study will confirm whether the advantage is sustained longer-term.
authors: National Centre In HIV Epidemiology And Clinical Research, UNSW, Sydney, Australia. gmatthews@nchecr.unsw.edu.au
authors: Gail V
authors: GV
authors: Matthews
authors: Eric
authors: E
authors: Seaberg
authors: Gregory J
authors: GJ
authors: Dore
authors: Scott
authors: S
authors: Bowden
authors: Sharon R
authors: SR
authors: Lewin
authors: Joe
authors: J
authors: Sasadeusz
authors: Pip
authors: P
authors: Marks
authors: Zachary
authors: Z
authors: Goodman
authors: Frances H
authors: FH
authors: Philp
authors: Yiwei
authors: Y
authors: Tang
authors: Stephen
authors: S
authors: Locarnini
authors: Chloe L
authors: CL
authors: Thio
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D019259:Lamivudine