Tenofovir (Viread)

Published October 02, 2001; Updated February 2013
Susa Coffey, MD
http://hivinsite.ucsf.edu/InSite?page=ar-01-07
Selected Reference
25. Nelson  M, Portsmouth  S, Stebbing  J, Atkins  M, Barr  A, Matthews  G, Pillay  D, Fisher  M, Bower  M, Gazzard  B.
An open-label study of tenofovir in HIV-1 and Hepatitis B virus co-infected individuals. AIDS. 2003 Jan;17(1):F7-10
[PubMed ID: 12478090]
Abstract:
BACKGROUND: Tenofovir is a novel nucleotide analogue recommended for use in HIV-1 infected treatment-experienced patients. Recent data suggest an effect on Hepatitis B virus (HBV) replication. We therefore investigated the use of tenofovir in HIV-1 and HBV co-infected individuals. METHODS: Twenty HIV-1/HBV co-infected patients with a median of 108 weeks lamivudine experience (range, 0-270 weeks) received tenofovir 245 mg daily in addition to or as part of their combination antiretroviral therapy. Their immunologic parameters and HIV-1 RNA and HBV DNA viral loads were followed over a period of 52 weeks. In addition, their HBV DNA polymerase was sequenced at baseline to measure the frequency of YMDD mutations that are associated with lamivudine resistance. FINDINGS: A significant decrease in HBV DNA viral load (4 x log ) and alanine aminotransferase levels was observed. There were no significant overall differences between the lamivudine-experienced (n = 15) and -naive (n = 5) individuals and tenofovir was well tolerated. Five patients (25%) underwent HBe antigen seroconversion during the study period. Out of the 15 lamivudine-experienced individuals, 10 had YMDD mutations and one had YIDD mutations in HBV DNA. INTERPRETATION: These results indicate that 52 weeks of tenofovir in addition to antiretroviral therapy is active against HBV, and it appears to overcome lamivudine resistance.