Virology and clinical sequelae of drug-resistant HBV in HIV-HBV-coinfected patients on highly active antiretroviral therapy.
Several of the nucleoside/nucleotide analogues used to treat HIV also inhibit HBV replication, with lamivudine being the oldest of this group. Thus, prior to licensing of tenofovir, many HIV-HBV-coinfected individuals received lamivudine as the only drug active against HBV as part of an anti-HIV regimen, which set the stage for the emergence of drug-resistant HBV. In coinfected persons, lamivudine-resistant HBV develops more rapidly than in HBV-monoinfected persons, but it is not known if this is true for the newer agents. Owing to overlapping reading frames of the HBV polymerase and surface antigens, drug-resistant changes in HBV Pol can lead to mutations in the envelope. This review will discuss studies of drug-resistant HBV in HIV-infected persons including drug-resistant mutations that have been identified and clinical sequelae of these mutations.
Johns Hopkins University, Baltimore, MD, USA. cthio@jhmi.edu
Chloe L
CL
Thio
D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000235:genetics; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000187:drug effects; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D009154:Mutation; D009705:Nucleosides / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use
D000998:Antiviral Agents; D009705:Nucleosides