April 16, 2013

ART for HIV May Protect Against HBV

Reuters Health Information


Apr 11, 2013

By David Douglas

NEW YORK (Reuters Health) Apr 11 - In a study of men with HIV, antiretroviral therapy (ART) with lamivudine or tenofovir disoproxil fumarate (TDF) appeared to protect against infection with hepatitis B virus (HBV), Japanese researchers say.

Dr. Hiroyuki Gatanaga of the National Center for Global Health and Medicine, Tokyo and colleagues evaluated stocked serum samples from HIV-infected men who have sex with men.

They found a lower frequency of incident HBV infection under lamivudine- and TDF-containing ART than under ART without lamivudine and TDF, or without ART at all, Dr. Gatanaga told Reuters Health by email, adding that "HBV-active ART seems to work as a pre-exposure prophylaxis against HBV."

As reported March 13th online in Clinical Infectious Diseases, the research team had access to "first stocked blood samples" from 1,434 HIV-infected men who hadn't been vaccinated against HBV; 354 were negative for all analyzed HBV serological markers.

During follow-up of the latter group, analysis of their last samples indicated HBV incident infection in 43 (12.1%).

Rates of incident infections per 100 person-years were 0.669 during lamivudine- or TDF-containing ART, 6.726 with no ART, and 5.263 with some other type of ART.

However, it seems that lamivudine-resistant strains may evade the drug's protective effect. These infections were more prevalent during ART with lamivudine (50%) than during no or other ART (7.1%).

In fact, Dr. Gatanaga added, "In order to prevent lamivudine-resistant HBV infection, TDF-ART should be used instead of (lamivudine)-ART."

Also, Dr. Gatanaga pointed out, "Some doctors are trying to use a NRTI-sparing regimen because they want to avoid NRTI toxicity such as mitochondrial damage. But NRTI-sparing regimens do not have HBV-prophylactic effects."

Dr. Gatanaga believes the same prophylactic effects should also work in women.

SOURCE: http://bit.ly/156fkzy

Clin Infect Dis 2013.


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