Combination HBV therapy is linked to greater HBV DNA suppression in a cohort of lamivudine-experienced HIV/HBV coinfected individuals.
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.
Matthews
Gail V
GV
National Centre In HIV Epidemiology And Clinical Research, UNSW, Sydney, Australia. gmatthews@nchecr.unsw.edu.au
Seaberg
Eric
E
Dore
Gregory J
GJ
Bowden
Scott
S
Lewin
Sharon R
SR
Sasadeusz
Joe
J
Marks
Pip
P
Goodman
Zachary
Z
Philp
Frances H
FH
Tang
Yiwei
Y
Locarnini
Stephen
S
Thio
Chloe L
CL
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
D019380:Anti-HIV Agents; D004279:DNA, Viral; D019259:Lamivudine