Lamivudine monotherapy-based cART is efficacious for HBV treatment in HIV/HBV coinfection when baseline HBV DNA <20,000 IU/mL

Yijia Li, Jing Xie, Yang Han, Huanling Wang, Ting Zhu, Nidan Wang, Wei Lv, Fuping Guo, Zhifeng Qiu, Yanling Li, Shanshan Du, Xiaojing Song, Chloe L. Thio, Taisheng Li

Research output: Contribution to journalArticle

Abstract

Background: Although combination antiretroviral therapy (cART) including tenofovir (TDF)+lamivudine (3TC) or emtricitabine (FTC) is recommended for treatment of HIV/HBV coinfected patients, TDF is unavailable in some resource-limited areas. Some data suggest that 3TC monotherapy-based cART may be effective in patients with low pretreatment HBV DNA. Methods: Prospective study of 151 Chinese HIV/HBV coinfected subjects of whom 60 received 3TC-based cART and 91 received TDF+3TC-based cART. Factors associated with HBV DNA suppression at 24 and 48 weeks, including anti-HBV drugs, baseline HBV DNA, and baseline CD4 cell count, were evaluated overall and stratified by baseline HBV DNA using Poisson regression with a robust error variance. Results: Baseline HBV DNA ≥20,000 IU/mL was present in 48.3% and 44.0% of subjects in the 3TC and TDF groups, respectively (P = 0.60). After 48 weeks of treatment, HBV DNA suppression rates were similar between these 2 groups (96.8% vs. 98.0% for 3TC and TDF+3TC, P > 0.999) in subjects with baseline HBV DNA <20,000 IU/mL; whereas in those with baseline HBV DNA ≥20,000 IU/mL, TDF+3TC was associated with higher suppression rates (34.5% vs. 72.5% in 3TC and TDF+3TC groups, respectively, P = 0.002). In stratified multivariate regression, TDF use (RR 1.98, P = 0.010) and baseline HBV DNA (per 1 log increase in International Units Per Milliliter, RR 0.74, P < 0.001) were associated with HBV DNA suppression only when baseline HBV DNA ≥20,000 IU/mL. Conclusion: This study suggests that 3TC monotherapy-based cART is efficacious for HBV treatment through 48 weeks in HIV/HBV coinfection when baseline HBV DNA<20,000 IU/mL. Studies with long-term follow-up are warranted to determine if this finding persists.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalJournal of acquired immune deficiency syndromes
Volume72
Issue number1
DOIs
StatePublished - May 1 2016

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Keywords

  • HBV
  • HIV
  • Hepatitis B surface antigen
  • Lamivudine
  • Tenofovir

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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