Hepatitis B virus (HBV) viremia despite tenofovir disoproxil fumarate-containing antiretroviral therapy in persons with HBV/HIV coinfection

作者：Patrick Ryan, Elizabeth Odegard, Heidi L. Meeds, Margaret Lartey, Vincent Ganu, Kenneth Tachi, Hongmei Yang, Oluwayemisi Ojewale, Isaac Boamah, Adjoa Obo-Akwa, K. Antwi, Peter L. Anderson, Jason T. Blackard, Awewura Kwara · 发表于：Journal of Clinical Virology · 年份：2024 · DOI：10.1016/j.jcv.2024.105733 · 被引用次数：7 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、HIV/AIDS drug development and treatment

BACKGROUND: The goal of treatment of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection is suppression of both viruses; yet incomplete HBV suppression on tenofovir (TFV) disoproxil fumarate (TDF)-based antiretroviral therapy (ART) is common. This study investigated TFV resistance-associated mutations (RAMs) in individuals with HBV/HIV coinfection with viremia on TDF/lamivudine (3TC)-containing ART. METHODS: Samples from individuals with HBV DNA levels ≥20 IU/mL in a cross-sectional study of 138 persons with HBV/HIV coinfection in Ghana were analyzed in the present study. HBV was sequenced for RAM analysis. TFV-diphosphate (TFV-DP) concentration in peripheral blood mononuclear cells (PBMCs) was used to assess ART adherence level. RESULTS: Nine of 138 participants (6.5 %) had detectable HBV DNA levels ≥20 IU/mL while on ART. Seven of the nine participants had TFV-DP concentrations commensurate with 7 doses per week, and six had suppressed HIV RNA. Phylogenetic analysis revealed that eight sequences were HBV genotype E, with one genotype E/A recombinant. Ten previously-reported TFV RAMs were present in the study samples; eight were wild-type for HBV genotype E. The non-genotype-E-wild-type point mutations M267L and K333Q were found in two and one patients, respectively. No 3TC RAMs were found. CONCLUSION: HBV viremia despite high adherence to TDF/3TC-based ART may be associated with the presence of TFV RAMs. These findings highlight the need for enhanced ...