Comparison of the antiviral activity of adefovir and tenofovir on hepatitis B virus in HIV-HBV-coinfected patients.

BACKGROUND: Characteristics and factors influencing viral decay under tenofovir (TDF) and adefovir (ADV) need to be determined in HIV-HBV-coinfected patients. METHODS: This open-label study compared the HBV dynamics in 85 HIV-HBV-coinfected patients initiating an antiretroviral regimen, either including TDF or associated with ADV. The first 6-month change in viral load was analysed using mixed linear models. The adjusted hazards ratio, comparing the rates of undetectable HBV DNA between treatments, was calculated using a Cox proportional hazard model. RESULTS: The HBV DNA decay, adjusted for baseline HBV viral load was more pronounced in patients treated with TDF than with ADV at 12 months (66% versus 53%, P=0.0001). Patients in the TDF group presented a steeper slope of decline at 1.1 (95% confidence interval [CI] 0.9-1.3), compared with 0.8 (95% CI 0.6-1.0) in the ADV group (P=0.036). The mean time to HBV DNA undetectability was 19.3 months (95% CI 16.7-22.0) with TDF and 25.9 months (95% CI 21.1-30.7) with ADV. When adjusted for hepatitis B virus e antigen, HBV DNA and alanine aminotransferase levels at baseline, the influence of treatment on time to HBV DNA undetectability remained in favour of TDF versus ADV (hazard ratio=2.79, 95% CI 1.05-7.40, P=0.039) CONCLUSIONS: TDF influenced more strongly the early-phase HBV DNA kinetics than ADV. This is associated with a sustained antiviral activity in the TDF group, in which patients reached the threshold of HBV undetectability at a faster rate and in a larger proportion than those taking ADV.

Mots clés

chronic hepatitis B HIV infection modelling tenofovir adefovir

Domaines

Maladies infectieuses

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ADV_TDF_figure_2_REVISED.pdf (12.61 Ko)

ADV_TDF_HAL.pdf (103.45 Ko)

ADV_TDF_figure_1_REVISED.pdf (48.32 Ko)

ADV_TDF_figure_3_REVISED.pdf (6.53 Ko)

ADV_TDF_tables_REVISED.pdf (17.41 Ko)

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https://inserm.hal.science/inserm-00325812

Soumis le : mardi 30 septembre 2008-14:01:13

Dernière modification le : mardi 16 avril 2024-17:00:03

Archivage à long terme le : mardi 18 septembre 2012-12:16:39

Dates et versions

inserm-00325812 , version 1 (30-09-2008)

Identifiants

HAL Id : inserm-00325812 , version 1
PUBMED : 18771054

Citer

Karine Lacombe, Joël Gozlan, Anders Boyd, Pierre-Yves Boelle, Philippe Bonnard, et al.. Comparison of the antiviral activity of adefovir and tenofovir on hepatitis B virus in HIV-HBV-coinfected patients.. Antiviral Therapy, 2008, 13 (5), pp.705-13. ⟨inserm-00325812⟩

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