AEGiS-ATDN: Treatment Notes: HBV

Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.

Treatment Notes: HBV

Information Bulletin #15 - May 2002

Treating HIV and HBV at the same time- Recent studies have started to clarify this question. At the 9th Retrovirus conference in February, A leading researcher Dr. Marion Peters recommended that HIV and HBV should be treated at the same time. She has observed that HBV does not kill liver cells by itself. The damage to the liver is actually caused by our own immune system's attack cells killing HBV as well as the infected liver cells. What this means is that if a co-infected person is only treating his/her HIV infection, as the immune system recover and become stronger, it will start to attack the liver if the person has a high HBV viral load, causing damage to the liver (fibrosis leading to cirrhosis). If you are currently treating only HIV and have a high HBV viral load, you should talk to your medical provider and consider treating both infections at the same time. IF you have HBV but have been "cleared", you should regularly check your HBV viral load and watch out for a rebound.

- tenofovir (Viread) - The latest anti-HIV drug tenofovir (Viread) has also been shown to be effective against lamivudine-resistant HBV. In a small group (12 people) of HIV/HBV co-infected patients in a clinical study showed a drop of 3.87 log in their HBV viral load after 24 weeks of treatment. If you are co-infected with HIV and HBV, You might want to have a discussion with your medical provider about the pros and cons of switching/adding tenofovir to your current combination therapy.

- entecavir/ETV - Another promising new treatment for HBV being developed by Bristol-Myers Squibb is called Entecavir/ETV. Studies seem to indicate that Entecavir/ETV is much more effective than current therapies and might have a much longer survival rate (currently > 4 years with standard therapy). Conclusions from these studies (150 people total) indicate that ETV is better than 3TC and little resistance is shown after 3 years of dosing. A new study for HIV/HBV co-infection is being designed. It will enroll 60 patients and adds ETV to current treatments. An expanded Access Program is planned.

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