Virological And Biochemical Evolution Of Hiv-Hbv Co-Infected Patients Treated With Tenofovir

Background: Tenofovir (TDF) is a nucleotide with dual activity against HIV and hepatitis B (HBV) viruses. Thus, it has become the antiviral of choice for HIV-HBV co-infected patients when treatment for both viral infections is indicated. Methods: We reviewed 19 medical records of patients who received tenofovir as part of the antiviral treatment. Five patients had previously received 3TC (lamivudine) as part of HAART. Immunological parameters were recorded for HIV infection (CD4/mm3), AST, ALT and viral loads for HIV and HBV were followed over an average period of 27 months (range, 3-44m). Results: All patients were male and the median age was 42 years (range, 29-65). Concomitant antiviral medications were 1 NRTI +1 NNRTI (3TC/FTC) in 13 patients, 1 ritonavir-boosted PI + 1 NNRTI in 1 patient, 1 PI + 1 NRTI (3TC or FTC) in 4 patients and 1 IP ritonavir-boosted + 2NRTI (AZT + 3TC) in 1 patient. The mean HBV DNA at baseline was: 6.53 log. Six patients presented at baseline with normal ALT and 13 a mean elevation of AST/ALT x 3,8/x 5. The results of liver biopsy were available for 6 patients: 1 had cirrhosis, 3 mild chronic hepatitis (stage 1), 2 moderate chronic hepatitis (stage 2). 17 patients were HBeAg positive, and two were HBeAg negative at baseline. Seven out of 17 patients underwent HBeAg loss and seroconversion to anti e. Loss of HBsAg was documented in 1 patient. HBV-DNA follow up was available in 17/19 patients (2/19 pending). 13/17 achieved HBV-DNA undetectability (mean 58 weeks). 4/17 reduced their HBV-DNA by a mean of 4.75 log (range: 3.1 to 6.2 log) with a mean follow up of 33 weeks. Among 13 patients who had abnormal ALT at baseline, 9 normalized during the follow up. Among patients previously experienced with 3TC: 4 achieved undetectable HBV DNA and the other decreased 6.2 log from baseline. Conclusion: As pointed out by the international literature, we found a high virological and biochemical efficacy of TDF in HIV-HBV co-infected patients, in terms of HBV antiviral inhibition in both previously treated with 3TC and naive patients. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive