Abstract
Background: Characteristics and factors influencing viral decay under tenofovir (TDF) and adefovir (ADV) need to be determined in HIV-HBV-coinfected patients. Methods: This open-label study compared the HBV dynamics in 85 HIV-HBV-coinfected patients initiating an antiretroviral regimen, either including TDF or associated with ADV. The first 6-month change in viral load was analysed using mixed linear models. The adjusted hazards ratio, comparing the rates of undetectable HBV DNA between treatments, was calculated using a Cox proportional hazard model. Results: The HBV DNA decay, adjusted for baseline HBV viral load was more pronounced in patients treated with TDF than with ADV at 12 months (66% Versus 53%, P=0.0001). Patients in the TDF group presented a steeper slope of decline at 1.1 (95% confidence interval [CI] 0.9-1.3), compared with 0.8 (95% CI 0.6-1.0) in the ADV group (P=0.036). The mean time to HBV DNA undetectability was 19.3 months (95% CI 16.7-22.0) with TDF and 25.9 months (95% CI 21.1-30.7) with ADV. When adjusted for hepatitis B virus e antigen, HBV DNA and alanine aminotransferase levels at baseline, the influence of treatment on time to HBV DNA undetectability remained in favour of TDF versus ADV (hazard ratio=2.79, 95% CI 1.05-7.40, P=0.039) Conclusions: TDF influenced more strongly the early-phase HBV DNA kinetics than ADV. This is associated with a sustained antiviral activity in the TDF group, in which patients reached the threshold of HBV undetectability at a faster rate and in a larger proportion than those taking ADV. © 2008 International Medical Press.
Original language | English |
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Pages (from-to) | 705-713 |
Number of pages | 9 |
Journal | Antiviral therapy |
Volume | 13 |
Issue number | 5 |
Publication status | Published - 2008 |
Externally published | Yes |
Keywords
- Adenine/analogs & derivatives
- Adult
- Antiviral Agents/pharmacology
- DNA, Viral/blood
- Drug Therapy, Combination
- Female
- HIV Infections/complications
- Hepatitis B virus/drug effects
- Hepatitis B/complications
- Humans
- Male
- Middle Aged
- Organophosphonates/pharmacology
- Proportional Hazards Models
- Tenofovir
- Treatment Outcome
- Viral Load