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发表于 2002-12-25 13:07
Study Confirms Effectiveness of Viread (Tenofovir) in Treating HBV
By Brian Boyle, MD
Due to shared routes of infection, many patients with HIV are also co-infected with hepatitis B virus (HBV). There are currently 3 FDA-Approved treatments for chronic HBV: Intron A (interferon alfa), Epivir-HBV (lamivudine, 3TC) and Hepsera (adefovir dipivoxil).
Clearly additional therapies are needed for HBV and there are many drugs being developed. One drug that has recently been approved for HIV therapy, the nucleotide analogue Viread (tenofovir), has also been shown to have significant HBV activity, even against 3TC-resistant HBV variants.
In a recent 24-week pilot study, published in The Journal of Infectious Diseases, investigators prospectively evaluated the anti-HBV activity of Viread in a cohort of 6 HIV co-infected subjects for whom Epivir-HBV and interferon therapy had previously failed as indicated by an HBV viral load >106 copies/mL while receiving Epivir-HBV or Coviracil (emtricitabine, FTC) treatment, persistent positive hepatitis B surface antigen (HBsAg), and absence of HBV surface (HBs) or e (HBe) antibody.
At baseline, all of the enrolled patients were taking Epivir-HBV or Coviracil and were HBsAg and hepatitis B e antigen (HBeAg) positive. The median baseline HBV viral load in the enrolled patients was 7.95 log10 copies/mL. By weeks 12 and 24, the median HBV viral load had decreased by 3.1 log10 copies/mL and 4.3 log10 copies/mL, respectively (p < .0001). There was a transient, but insignificant, increase of transaminases after the initiation of treatment. While 2 patients achieved an undetectable HBV viral load at week 24 of treatment, no patient developed HBe antibodies.
The authors conclude, "Hepatitis B is a potentially controllable disease that occurs very frequently in HIV-infected individuals, especially in some risk groups. Aggressive treatment of this coinfection will hopefully lead to an improved tolerability of antiretroviral therapy and decreased morbidity and mortality associated with it. TDF is a very promising drug for this indication that needs to be evaluated in the setting of prospective, randomized trials."
12/11/02
Reference
M Ristig and others. Tenofovir Disoproxil Fumarate Therapy for Chronic Hepatitis B in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Individuals for Whom Interferon-a and Lamivudine Therapy Have Failed. The Journal of Infectious Diseases. 2002; 186:1844-7.
Copyright 2002 by HIV and Hepatitis.com. All Rights Reserved.
Reproduction of articles for personal or educational use is encouraged and does not require permission from the publisher. Permission to re-print copyrighted articles is almost always granted, but does require written permission from the publisher (email [email protected])
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