Evaluation of Chronic Hepatitis B Virus (HBV) Infection in Coinfected Patients Receiving Lamivudine as a Component of Anti-Human Immunodeficiency Virus Regimens

J. Hoff, F. Bani-Sadr, M. Gassin, F. Raffi
2001 Clinical Infectious Diseases  
The effect of lamivudine on chronic coinfection with hepatitis B virus (HBV) in human immunodeficiency virus (HIV)-infected patients was studied prospectively. Nineteen patients with HIV infection , who were receiving an anti-HIV regimen containing lamivudine (150 mg twice daily), and who had replicative chronic HBV infection, were followed for a median of 14 months. Twelve patients' regimens contained protease inhibitors. Serum HBV DNA became undetectable, by means of molecular hybridization,
more » ... lar hybridization, in 14. Seroconversion of hepatitis B e antigen to antibody occurred in 6 of 17 patients, and seroconversion of hepatitis B surface antigen to antibody occurred in 1 of 19. The median serum alanine aminotransferase concentration had decreased by the time of the final evaluation. The median CD4 cell count increased and plasma HIV RNA was undetectable in 10 of 19 patients. Five patients had recurrence of detectable serum HBV DNA despite good compliance with treatment, and 2 mutations related to the resistance of HBV were detected. These patients had a significantly longer duration of treatment (21 versus 13 months; ). In conclusion, resistant P ! .05 strains of HBV emerge at high detectable levels while patients receive anti-HIV regimens containing lamivudine. Coinfection with hepatitis B virus (HBV) and HIV is frequent because the modes of transmission are common to both infections [1] . HIV infection has a significant effect on the natural history of HBV infection. Persistent HBV infection is likely to develop in HIVinfected patients, and reactivation may occur despite seroconversion to antibody to HBV surface antigen (HBsAg), particularly if the CD4 cell count is low [2, 3] . Such infections, compared with those that occur in immunocompetent patients, are characterized by high levels of viral replication and low rates of loss of serum hepatitis B e antigen (HBeAg): a 3% loss of serum HBV
doi:10.1086/319368 pmid:11247719 fatcat:tw3u6xhyareuvj4txre4bhc3mm