title: HBV lamivudine resistance among hepatitis B and HIV coinfected patients starting lamivudine, stavudine and nevirapine in Kenya.
abstract: Widespread use of lamivudine in antiretroviral therapy may lead to hepatitis B virus resistance in HIV-HBV coinfected patients from endemic settings where tenofovir is not readily available. We evaluated 389 Kenyan HIV-infected adults before and for 18 months after starting highly active antiretroviral therapy with stavudine, lamivudine and nevirapine. Twenty-seven (6.9%) were HBsAg positive and anti-HBs negative, 24 were HBeAg negative, and 18 had HBV DNA levels ≤ 10,000 IU/mL. Sustained HBV suppression to <100 IU/mL occurred in 89% of 19 evaluable patients. Resistance occurred in only two subjects, both with high baseline HBV DNA levels. Lamivudine resistance can emerge in the setting of incomplete HBV suppression but was infrequently observed among HIV-HBV coinfected patients with low baseline HBV DNA levels.
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA 98104, USA. hyangkim@uw.edu
authors.forename: H N
authors.initials: HN
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Scott
authors.forename: A
authors.initials: A
authors.lastname: Cent
authors.forename: L
authors.initials: L
authors.lastname: Cook
authors.forename: R A
authors.initials: RA
authors.lastname: Morrow
authors.forename: B
authors.initials: B
authors.lastname: Richardson
authors.forename: K
authors.initials: K
authors.lastname: Tapia
authors.forename: K R
authors.initials: KR
authors.lastname: Jerome
authors.forename: G
authors.initials: G
authors.lastname: Lule
authors.forename: G
authors.initials: G
authors.lastname: John-Stewart
authors.forename: M H
authors.initials: MH
authors.lastname: Chung
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D004279:DNA, Viral / Q000097:blood; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007630:Kenya; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D019829:Nevirapine / Q000008:administration & dosage; D018119:Stavudine / Q000008:administration & dosage; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine; D019829:Nevirapine; D018119:Stavudine