title: In vivo antiviral activity of telbivudine against HIV-1: a case report.
abstract: The treatment of HBV infection in patients with HIV co-infection presents several peculiar features: some drugs active against HBV are also active against HIV. This precludes their use in monotherapy in HIV-HBV co-infected patients due to the potential risk of selecting HIV-resistant strains. Telbivudine seemed to be a candidate for exclusive anti-HBV therapy because it exerts no significant in vitro activity against HIV. In this context, we describe the case of a HIV-HBV co-infected patient who presented indication for treatment only for HBV infection. After a short course of interferon treatment withdrawn due to adverse events, adefovir monotherapy was started. Since no significant viral drop was achieved during adefovir treatment, telbivudine was added. This treatment was associated with a complete virological response on HBV. It is noteworthy that after two months of this treatment even the HIV viral load presented a significant reduction. Our findings pose concerns of possible antiviral activity of telbivudine against HIV and therefore of selecting resistant mutations.
authors.affiliation: Department of Clinical Medicine and Surgery, Section of Infectious Diseases; Department of Cellular and Molecular Biology and Pathology, University of Naples Federico II, Naples, Italy.
authors.forename: Ivan
authors.initials: I
authors.lastname: Gentile
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bonadies
authors.forename: Maria Aurora
authors.initials: MA
authors.lastname: Carleo
authors.forename: Antonio Riccardo
authors.initials: AR
authors.lastname: Buonomo
authors.forename: Francesco
authors.initials: F
authors.lastname: Borrelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Portella
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Borgia
mesh_terms: D000208:Acute Disease; D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006509:Hepatitis B / Q000188:drug therapy*; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D063065:Organophosphonates / Q000627:therapeutic use; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D000077712:Telbivudine; C053001:adefovir; D000225:Adenine; D013936:Thymidine