title: Telbivudine in the treatment of chronic hepatitis B: experience in HIV type-1-infected patients naive for antiretroviral therapy.
abstract: BACKGROUND
  Telbivudine is a potent inhibitor of hepatitis B virus (HBV) replication without anti-HIV type-1 (HIV-1) activity demonstrated in vitro; however, very few clinical data on HIV-1-infected patients are available at present. Because it represents a therapeutic option in HIV-1-HBV-coinfected patients who do not require antiretroviral therapy, we strictly monitored three HIV-1-HBV-coinfected patients treated with telbivudine monotherapy for chronic hepatitis B.
  
  
  METHODS
  We performed molecular analysis of HBV DNA and of HIV-1 reverse transcriptase and protease RNA and DNA sequences in three HIV-1-HBV-coinfected patients treated with telbivudine monotherapy.
  
  
  RESULTS
  Despite a transient and deep reduction of HIV-1 RNA, observed in two of the three patients studied, no genotypic resistance mutations were detected on both HIV-1 and HBV viruses.
  
  
  CONCLUSIONS
  Telbivudine therapy for 24 weeks showed a potent anti-HBV activity in HIV-1-positive, hepatitis B e antigen-positive patients with high HBV viraemia. No direct anti-HIV-1 activity of telbivudine was demonstrated and no genotypic resistance mutations to anti-HIV-1 drugs was found; however, the transient but deep reduction of HIV RNA, after telbivudine introduction, deserves further investigation and a strict monitoring of HIV-1 viraemia in HIV-1-infected patients on treatment with this drug.
authors.affiliation: Department of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Milan, Italy. laura.milazzo@unimi.it
authors.forename: Laura
authors.initials: L
authors.lastname: Milazzo
authors.forename: Ilaria
authors.initials: I
authors.lastname: Caramma
authors.forename: Alessia
authors.initials: A
authors.lastname: Lai
authors.forename: Michela
authors.initials: M
authors.lastname: Violin
authors.forename: Chiara
authors.initials: C
authors.lastname: De Maddalena
authors.forename: Miriam
authors.initials: M
authors.lastname: Cesari
authors.forename: Massimo
authors.initials: M
authors.lastname: Galli
authors.forename: Claudia
authors.initials: C
authors.lastname: Balotta
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents; D000998:Antiviral Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009705:Nucleosides / Q000627:therapeutic use*; D011744:Pyrimidinones / Q000627:therapeutic use*; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D009705:Nucleosides; D011744:Pyrimidinones; D000077712:Telbivudine; D013936:Thymidine