Prolonged lamivudine therapy has been identified as the major risk for the development of resistance in HBV, with rates of 90% after 4 years of treatment. Tenofovir disoproxil fumarate showed activity against both wild type and lamivudine resistant HBV in HIV-HBV co-infected patients. In order to compare the efficacy of lamivudine/tenofovir treatment we investigated detailed HBV kinetics in 13 HIV-HBV co-infected patients with either wild type HBV or lamivudine resistant HBV. The viral strains in both patient groups showed a biphasic viral decline pattern. Only in the first phase of viral decay, which reflects the clearance rate of the free virus from plasma, there was a statistically significant response in favor of the wild type group. After the first phase we observed a similar viral decline till 24 weeks of both groups. This is reassuring for many pretreated co-infected patients harbouring mutant viruses.

HBV, HIV, Lamivudine, Tenofovir, Viral dynamics, YMDD,
Journal of Clinical Virology
Department of Virology

de Vriessluijs, T.E.M.S, Eijck, A.A, Hansen, B.E, Osterhaus, A.D.M.E, de Man, R.A, & van der Ende, M.E. (2006). Wild type and YMDD variant of hepatitis B virus: No difference in viral kinetics on lamivudine/tenofovir therapy in HIV-HBV co-infected patients. Journal of Clinical Virology, 36(1), 60–63. doi:10.1016/j.jcv.2005.12.004