Titre du document / Document title

Combination of tenofovir and lamivudine versus tenofovir after lamivudine failure for therapy of hepatitis B in HIV-coinfection

Auteur(s) / Author(s)

SCHMUTZ Guenther ⁽¹⁾ ; NELSON Mark ⁽²⁾ ; LUTZ Thomas ⁽³⁾ ; SHELDON Julie ⁽⁴⁾ ; BRUNO Raffaele ⁽⁵⁾ ; VON BOEMMEL Florian ⁽⁶⁾ ; HOFFMANN Christian ⁽⁷⁾ ; ROCKSTROH Juergen ⁽⁸⁾ ; STOEHR Albrecht ⁽⁷⁾ ; WOLF Eva ⁽⁹⁾ ; SORIANO Vincent ⁽⁴⁾ ; BERGER Florian ⁽¹⁾ ; BERG Thomas ⁽⁶⁾ ; CARLEBACH Amina ⁽³⁾ ; SCHWARZE-ZANDER Carolynne ⁽⁸⁾ ; SCHÜRMANN Dirk ⁽⁶⁾ ; JAEGER Hans ⁽⁹⁾ ; MAUSS Stefan ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Center for HIV and Hepatogastroenterology, Duesseldorf, ALLEMAGNE
⁽²⁾ Kobler Clinic, Chelsea and Westminster Hospital, London, ROYAUME-UNI
⁽³⁾ HIV-cohort Frankfurt, ALLEMAGNE
⁽⁴⁾ Hospital Carlos III, Madrid, ESPAGNE
⁽⁵⁾ San Matteo Hospital, University of Pavia, ITALIE
⁽⁶⁾ Medizinische Klinik Charité, Berlin, ALLEMAGNE
⁽⁷⁾ Institute for Interdisciplinary Infectiology and Immunology, Hamburg, ALLEMAGNE
⁽⁸⁾ Med. Klinik I, Universitaetsklinikum Bonn, ALLEMAGNE
⁽⁹⁾ MUC Research, Munich, ALLEMAGNE

Résumé / Abstract

Objective: At present sequential monotherapy for chronic hepatitis B with hepatitis B virus (HBV)-polymerase inhibitors is clinical practice. It is unknown to date whether combination therapy with lamivudine plus tenofovir could be superior to sequential therapy with tenofovir after the occurrence of lamivudine resistance. Methods: We conducted a multicenter, 1 : 2 matched pair analysis comparing patients with HBV/HIV-coinfection starting an antiretroviral regimen including tenofovir plus lamivudine with patients who had highly replicative, lamivudine resistant HBe-antigen positive chronic hepatitis B and started with tenofovir as the only active HBV polymerase inhibitor subsequent to lamivudine. Results: At baseline patients on tenofovir plus lamivudine (n = 25) had a median HBV DNA of 5.9 x 10⁷ copies/ml compared to 1.37 x 10⁸copies/ml in the tenofovir arm (n = 50; P = 0.32). A sustained undetectable HBV DNA < 1000 copies/ml was achieved in 19/25 (76%) patients on tenofovir plus lamivudine and in 42/50 (84%) on tenofovir (P = 0.53). A loss of HBe-antigen was observed in 9/25 (36%) patients on tenofovir plus lamivudine and in 12/50 (24%) patients on tenofovir (P=0.29). HBs-antigen loss was found in 1/25 (4%) and 3/50 (6%) patients. Conclusions: In this cohort of HBV/HIV-coinfected individuals, full HBV DNA suppression was achieved in the majority of patients independent of treatment allocation. Loss of HBe- and HBs-antigen was not different between the two study arms. Over a median treatment period of 116 weeks tenofovir was as effective as tenofovir plus lamivudine. Longer treatment periods may be needed to evaluate potential benefits of first-line combination therapy for chronic hepatitis B.

Revue / Journal Title

AIDS   ISSN 0269-9370 

Source / Source

2006, vol. 20, n^o15, pp. 1951-1954 [4 page(s) (article)] (13 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1987) (Revue)

Mots-clés anglais / English Keywords

Immunopathology ; Immune deficiency ; Hepatic disease ; Digestive diseases ; Nucleoside analog ; Pyrimidine nucleoside ; Dideoxynucleoside ; Enzyme ; Transferases ; Nucleotidyltransferases ; RNA-directed DNA polymerase ; Purine nucleotide ; Organic phosphonate ; Acyclic nucleotide ; Reverse transcriptase inhibitor ; Enzyme inhibitor ; Infection ; Viral disease ; Antiretroviral agent ; Antiviral ; Drug combination ; Combined treatment ; Failure ; Comparative study ; Lamivudine ; Tenofovir ; Mixed infection ; AIDS ; Viral hepatitis B ;

Mots-clés français / French Keywords

Inhibiteur de l'ADN polymérase ; Analogue nucléotide ; Immunopathologie ; Immunodéficit ; Foie pathologie ; Appareil digestif pathologie ; Analogue nucléoside ; Pyrimidine nucléoside ; Didésoxynucléoside ; Enzyme ; Transferases ; Nucleotidyltransferases ; RNA-directed DNA polymerase ; Purine nucléotide ; Phosphonate organique ; Nucléotide acyclique ; Inhibiteur reverse transcriptase ; Inhibiteur enzyme ; Infection ; Virose ; Monothérapie ; Antirétroviral ; Antiviral ; Association médicamenteuse ; Traitement associé ; Echec ; Etude comparative ; Lamivudine ; Ténofovir ; Infection mixte ; SIDA ; Hépatite virale B ;

Mots-clés espagnols / Spanish Keywords

Inmunopatología ; Inmunodeficiencia ; Hígado patología ; Aparato digestivo patología ; Análogo nucleósido ; Pirimidina nucleósido ; Didesoxinucleósido ; Enzima ; Transferases ; Nucleotidyltransferases ; RNA-directed DNA polymerase ; Purina nucleótido ; Fosfonato orgánico ; Nucleótido acíclico ; Inhibitor reverse transcriptase ; Inhibidor enzima ; Infección ; Virosis ; Antiretroviral ; Antiviral ; Asociación medicamentosa ; Tratamiento asociado ; Fracaso ; Estudio comparativo ; Lamivudina ; Tenofovir ; Infección mixta ; SIDA ; Hepatitis vírica B ;

Mots-clés d'auteur / Author Keywords

HBV/HIV-coinfection ; tenofovir ; lamivudine ; monotherapy ; combination therapy ;

Localisation / Location

INIST-CNRS, Cote INIST : 22094, 35400015727259.0070