Long-term outcome of primary non-responders to tenofovir therapy in HIV/HBV-co-infected patients: impact of HBV genotype G
Article first published online: 9 AUG 2011
© 2011 John Wiley & Sons A/S
Volume 32, Issue 1, pages 93–101, January 2012
How to Cite
Lada, O., Gervais, A., Branger, M., Peytavin, G., Roquebert, B., Collin, G., Fraqueiro, G., Moucari, R., Hamet, G., Martinot-Peignoux, M., Matheron, S. and Marcellin, P. (2012), Long-term outcome of primary non-responders to tenofovir therapy in HIV/HBV-co-infected patients: impact of HBV genotype G. Liver International, 32: 93–101. doi: 10.1111/j.1478-3231.2011.02601.x
- Issue published online: 7 DEC 2011
- Article first published online: 9 AUG 2011
- Manuscript Accepted: 8 JUN 2011
- Manuscript Received: 5 JAN 2011
- delayed response to tenofovir;
- HBV genotype G;
To evaluate the early virological response (EVR) to combined tenofovir-lamivudine or emtricitabine regimen in HBV/HIV-co-infected patients and the long-term efficacy of tenofovir.
In this retrospective monocentric study, among the 166 HIV/HBV-co-infected patients regularly followed from 2003 to 2008 at Bichat Claude Bernard Hospital, 61 patients had received, either de novo combination therapy with tenofovir and lamivudine or emtricitabine (group I, n = 15) or add-on tenofovir to lamivudine therapy (group II, n = 46). The HBV polymerase region was sequenced and analysed for all patients with available samples.
All 15 group I patients achieved EVR vs 32 (82%) of group II patients (P = 0.15). Seven adherent group II patients met criteria for primary non-response, but achieved delayed response (DR) to therapy. In these seven patients, when compared with the 39 group II patients, there was a trend to longer duration of lamivudine pre-treatment and to higher rate of lamivudine-resistant mutants; and HBV genotype-G proportion was higher (P = 0.026). No virological breakthrough occurred after a median of 46 months follow up.
In these HBV/HIV-co-infected patients, first-line HBV therapy with tenofovir and emtricitabine or lamivudine was associated with EVR. However, DR to tenofovir was observed in 15% of patients who added tenofovir to lamivudine therapy, of whom four of seven (57%) had genotype G-HBV infection. No resistance was evidenced after 46 months of therapy even in patients with DR to tenofovir. At last, a good renal safety profile of TDF was observed after a median follow-up of 4 years of therapy.