March 8, 2013
Formulations of antiretroviral therapy (ART) that also are effective against hepatitis B protect HIV-infected patients from primary hepatitis B infections, according to a study led by Kees Brinkman at Amsterdam's Onze Lieve Vrouwe Gasthuis. Brinkman's team undertook the retrospective study because the rate of new hepatitis B infections in Amsterdam's largest HIV clinic had dropped to "very low" levels; they suspected ART with "dual" activity against HIV and hepatitis B might have reduced new hepatitis B infections. ART combinations effective against both HIV and hepatitis B include tenofovir (Viread, also in Truvada, Atripla, Complera, and Stribild), 3TC (lamivudine, Epivir), and FTC (emtricitabine, Emtriva).
The study included nearly 3,000 clinic patients, 2,280 of whom were men who have sex with men. At baseline, 51 percent were HIV- and hepatitis B-coinfected, 13 percent had been vaccinated for hepatitis B, and 30 percent were still susceptible to hepatitis B. Second samples of the participants who were hepatitis B-susceptible indicated that 530 remained hepatitis B-susceptible, 171 had been vaccinated for hepatitis B, and 35 patients had new hepatitis B infections. Researchers zeroed in on 350 HIV-infected patients who were not yet infected with hepatitis B, and for whom subsequent samples were available, to determine whether their hepatitis B status had changed.
Brinkman reported that HIV-infected people who did not receive dually active ART became infected with hepatitis B much sooner than people taking ART that also acts against hepatitis B. ART containing tenofovir was the combination most effective in preventing hepatitis B. Brinkman presented the study results during the 20th Conference on Retroviruses and Opportunistic Infections.
A webcast of the presentation, "Protective Effect of Hepatitis B Virus-active cART Against Primary Hepatitis B Virus Infection," was published online by the 20th Conference on Retroviruses and Opportunistic Infections at webcasts.retroconference.org/console/player/19410?mediaType=podiumVideo.