Publications & Reports

Patterns and causes of suboptimal response to tenofovir based therapy in HIV-HBV infected individuals.

Matthews GV, Seaberg EC, Avihingsanon A, Bowden S, Dore GJ, Lewin SR, Sasadeusz J, Revill PA, Littlejohn M, Hoy JF, Finlayson R, Ruxrungtham K, Saulynas M, Locarnini S, Thio CL
The Kirby Institute, University of New South Wales, Sydney, Australia.


Background. Tenofovir disproxil fumarate (TDF) is effective for hepatitis B (HBV) treatment in HIV infection; however, some individuals have ongoing HBV viraemia, the reasons for which are unclear. In this study, we determined the patterns and factors associated with detectable HBV DNA in HIV-HBV co-infected subjects on HAART.Methods. 165 HIV-HBV coinfected individuals from United States, Australia, and Thailand, the majority of whom were on HAART at study entry, were prospectively followed semiannually for a median of 2.8 years. Logistic regression was used to determine factors associated with detectable HBV DNA.Results. Anti-HBV regimens were TDF/emtricitabine (57%), lamivudine or emtricitabine (19%), or TDF monotherapy (13%). During follow-up, HBV DNA was detected at 21% of study visits and was independently associated with HBeAg, HAART 1 log from nadir), and viral blips. No TDF resistance was identified.Conclusion. Tenofovir/emtricitabine was superior to other anti-HBV regimens in long-term HBV suppression. HBV viraemia on therapy was identified in one of three main patterns. Suboptimal adherence was associated with detectable HBV DNA during therapy, even when HIV was undetectable.


  • Journal: Clinical Infectious Diseases
  • Published: 11/01/2013
  • Volume: 56
  • Issue: 9
  • Pagination: e87-e94

Health Issue