1. Long-term outcome of primary non-responders to tenofovir therapy in HIV/ HBV-co-infected patients: impact of HBV genotype G.
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Lada, Olivier, Gervais, Anne, Branger, Michel, Peytavin, Gilles, Roquebert, Benedicte, Collin, Gilles, Fraqueiro, Gil, Moucari, Rami, Hamet, Gwen, Martinot-Peignoux, Michelle, Matheron, Sophie, and Marcellin, Patrick more...
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HIV-positive persons ,TENOFOVIR ,LAMIVUDINE ,DRUG efficacy ,EMTRICITABINE - Abstract
Aim To evaluate the early virological response ( EVR) to combined tenofovir-lamivudine or emtricitabine regimen in HBV/ HIV-co-infected patients and the long-term efficacy of tenofovir. Methods In this retrospective monocentric study, among the 166 HIV/ HBV-co-infected patients regularly followed from 2003 to 2008 at Bichat Claude Bernard Hospital, 61 patients had received, either de novo combination therapy with tenofovir and lamivudine or emtricitabine (group I, n = 15) or add-on tenofovir to lamivudine therapy (group II, n = 46). The HBV polymerase region was sequenced and analysed for all patients with available samples. Results All 15 group I patients achieved EVR vs 32 (82%) of group II patients ( P = 0.15). Seven adherent group II patients met criteria for primary non-response, but achieved delayed response ( DR) to therapy. In these seven patients, when compared with the 39 group II patients, there was a trend to longer duration of lamivudine pre-treatment and to higher rate of lamivudine-resistant mutants; and HBV genotype-G proportion was higher ( P = 0.026). No virological breakthrough occurred after a median of 46 months follow up. Conclusion In these HBV/ HIV-co-infected patients, first-line HBV therapy with tenofovir and emtricitabine or lamivudine was associated with EVR. However, DR to tenofovir was observed in 15% of patients who added tenofovir to lamivudine therapy, of whom four of seven (57%) had genotype G- HBV infection. No resistance was evidenced after 46 months of therapy even in patients with DR to tenofovir. At last, a good renal safety profile of TDF was observed after a median follow-up of 4 years of therapy. [ABSTRACT FROM AUTHOR] more...
- Published
- 2012
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