title: Prophylactic effect of antiretroviral therapy on hepatitis B virus infection.
abstract: BACKGROUND
  Hepatitis B virus (HBV) infection is common in individuals infected with human immunodeficiency virus, especially in men who have sex with men (MSM). Almost all currently used regimens of antiretroviral therapy (ART) contain lamivudine (LAM) or tenofovir disoproxil fumarate (TDF), both of which have significant anti-HBV activity. However, the prophylactic effect of ART on HBV infection has not been assessed previously.
  
  
  METHODS
  Non-HBV-vaccinated HIV-infected MSM were serologically evaluated for HBV infection using stocked serum samples. Cases negative for HBV surface antigen (HBsAg), antibody to HBsAg (anti-HBs), and antibody to HBV core antigen (anti-HBc) in first serum samples were serologically followed until last available stocked samples. HBV genotype and LAM-resistant mutation (rtM204V/I) were analyzed in cases that became HBsAg-positive.
  
  
  RESULTS
  The first stocked samples were negative for all analyzed HBV serological markers in 354 of 1434 evaluated patients. The analysis of their last samples indicated HBV incident infection in 43 of them during the follow-up period. The rate of incident infections was lower during LAM- or TDF-containing ART (0.669 incident infections in 100 person-years) than during no ART period (6.726 incident infections in 100 person-years) and other ART (5.263 incident infections in 100 person-years) (P < .001). Genotype A was most prevalent (76.5%), and LAM-resistant HBV was more frequent in incident infections during LAM-containing ART (50.0%) than in those during no ART and other ART (7.1%) (P = .029).
  
  
  CONCLUSIONS
  LAM- and TDF-containing ART regimens seem to provide prophylaxis against HBV infection, although drug-resistant strains seem to evade these effects.
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan. higatana@acc.ncgm.go.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Gatanaga
authors.forename: Tsunefusa
authors.initials: T
authors.lastname: Hayashida
authors.forename: Junko
authors.initials: J
authors.lastname: Tanuma
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology*; D006509:Hepatitis B / Q000097:blood / Q000276:immunology / Q000517:prevention & control* / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology; D006512:Hepatitis B Core Antigens / Q000097:blood / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D006801:Humans; D053208:Kaplan-Meier Estimate; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D063065:Organophosphonates / Q000627:therapeutic use; D012189:Retrospective Studies; D000068698:Tenofovir
chemical_list: D044966:Anti-Retroviral Agents; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D063065:Organophosphonates; D019259:Lamivudine; D000068698:Tenofovir; D000410:Alanine Transaminase; D000225:Adenine
keywords: chronic infection; lamivudine; resistant; tenofovir disoproxil fumarate