Lamivudine plus tenofovir combination therapy versus lamivudine monotherapy for HBV/HIV coinfection: a meta-analysis

Luo, Aoran; Jiang, Xiaoyan; Ren, Hong

doi:10.1186/s12985-018-1050-3

Cited by 11 publications

(4 citation statements)

References 23 publications

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“…The causes of this heterogeneity should be identified, as long-term treatment resulted in higher rates of HBeAg loss and seroconversion. The combination of TDF + 3TC/FTC seemed to be more effective in patients with documented 3TC resistance (Luo et al, 2018). Differences in immune restoration after ART initiation were observed, with various rates of HBeAg seroclearance, as a sudden increase in CD4 + T-cell counts may promote a rapid immune response (Miailhes et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Immunological Efficacy of Tenofovir Disproxil Fumarate-Containing Regimens in Patients With HIV-HBV Coinfection: A Systematic Review and Meta-Analysis

Jiang

Song

et al. 2019

Front. Pharmacol.

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Background: Hepatitis B virus (HBV) coinfection is common in HIV-positive patients. HIV infection modifies the natural course of HBV infection, leading to a faster progression of liver-related morbidity and mortality than is observed in HBV mono-infected patients. This systematic review and meta-analysis evaluates the current clinical evidence regarding the use of oral tenofovir disproxil fumarate (TDF)-based treatments in patients coinfected with HIV and HBV.Methods: We performed a comprehensive literature search in PubMed and Web of Science. Supplementary searches were conducted in Google Scholar and Clinicaltrials.gov. We conducted a random effects meta-analysis using the event rate (ER) to estimate the incidence of HBV seroconversion. A subgroup meta-analysis was performed to assess the moderate effects of demographic and disease-related variables on HBsAg loss. This review is registered in the PROSPERO database (CRD42018092379).Results: We included 11 studies in the review. The immunological effects of oral TDF-based Pre-exposure prophylaxis (PrEP) treatment in patients with HIV-HBV coinfection were 0.249 for HBeAg loss, 0.237 for HBeAg conversion, 0.073 for HBsAg loss, and 0.055 for HBsAg conversion. The factors associated with HBsAg loss were the baseline HBV viral load, participant’s location, and a history of exposure to lamivudine/emtricitabine (3TC/FTC) (all p < 0.05). A trend toward a negative relationship between the baseline CD4+ T-cell count and HBsAg loss was observed (p = 0.078).Conclusion: This systematic review and meta-analysis demonstrated that TDF-containing regimens are effective at stimulating HBeAg loss (24.9%), HBeAg conversion (23.7%), HBsAg loss (7.3%), and HBsAg conversion (5.5%) in HIV-HBV coinfected patients. The moderator analysis showed that HBV viral load, the location of participants, and prior exposure to 3TC/FTC are factors associated with HBsAg loss. Asian ethnicity, prior exposure to 3TC, and a nondetectable baseline HBV viral load are associated with lower odds of HBsAg loss. Well-designed prospective cohort studies and randomized controlled trials (RCTs) with large sample sizes are required for the investigation of potential predictors and biological markers associated with strategies for achieving HBV remission in patients with HIV-HBV coinfection, which is a matter of considerable importance to clinicians and those responsible for health policies.

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Section: Discussionmentioning

confidence: 99%

Immunological Efficacy of Tenofovir Disproxil Fumarate-Containing Regimens in Patients With HIV-HBV Coinfection: A Systematic Review and Meta-Analysis

Jiang

Song

et al. 2019

Front. Pharmacol.

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“…This group of drugs has been routinely used in the treatment of viral infections for many years ( Luo et al, 2018 ; Keam, 2007 ; Rachlis, 1990 ; Jordan et al, 2018 ; Churchill et al, 2016 ; Organization, 2018 ). It is characterized by high affinity to viral enzymes and low affinity to human enzymes.…”

Section: Nucleotide and Nucleoside Analogsmentioning

confidence: 99%

FDA approved drugs with pharmacotherapeutic potential for SARS-CoV-2 (COVID-19) therapy

Drożdżal

Rosik

Lechowicz

et al. 2020

Drug Resistance Updates

131

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In December 2019, a novel SARS-CoV-2 coronavirus emerged, causing an outbreak of life-threatening pneumonia in the Hubei province, China, and has now spread worldwide, causing a pandemic. The urgent need to control the disease, combined with the lack of specific and effective treatment modalities, call for the use of FDA-approved agents that have shown efficacy against similar pathogens. Chloroquine, remdesivir, lopinavir/ritonavir or ribavirin have all been successful in inhibiting SARS-CoV-2 in vitro . The initial results of a number of clinical trials involving various protocols of administration of chloroquine or hydroxychloroquine mostly point towards their beneficial effect. However, they may not be effective in cases with persistently high viremia, while results on ivermectin (another antiparasitic agent) are not yet available. Interestingly, azithromycin, a macrolide antibiotic in combination with hydroxychloroquine, might yield clinical benefit as an adjunctive. The results of clinical trials point to the potential clinical efficacy of antivirals, especially remdesivir (GS-5734), lopinavir/ritonavir, and favipiravir. Other therapeutic options that are being explored involve meplazumab, tocilizumab, and interferon type 1. We discuss a number of other drugs that are currently in clinical trials, whose results are not yet available, and in various instances we enrich such efficacy analysis by invoking historic data on the treatment of SARS, MERS, influenza, or in vitro studies. Meanwhile, scientists worldwide are seeking to discover novel drugs that take advantage of the molecular structure of the virus, its intracellular life cycle that probably elucidates unfolded-protein response, as well as its mechanism of surface binding and cell invasion, like angiotensin converting enzymes-, HR1, and metalloproteinase inhibitors.

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“…However, another study reported no difference in effect between TDF monotherapy versus combined therapy of TDF and 3TC/FTC in managing chronic HBV infection among HBV monoinfected individuals (28). Among HIV/HBV coinfected individuals, a combination of 3TC and TDF is considered more efficacious compared to 3TC monotherapy among HIV/HBV coinfected individuals (29).…”

Section: Discussionmentioning

confidence: 99%

Evidence of Tenofovir Resistance in Chronic Hepatitis B Virus (HBV) Infection: An Observational Case Series of South African Adults

Mokaya

Maponga

McNaughton

et al. 2020

Preprint

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Introduction: Tenofovir disoproxil fumarate (TDF) is widely recommended for treatment of chronic hepatitis B virus (HBV) infection because it is safe, affordable and has a high genetic barrier to resistance. TDF resistance associated mutations (RAMs) have been reported, but data are limited, particularly for Africa. We set out to identify RAMs in individuals with detectable HBV viraemia on TDF treatment. Methods: We recruited adults with chronic HBV infection from Cape Town, South Africa, identifying individuals with a TDF resistance phenotype, defined as persistent HBV vireamia despite >12 months of TDF treatment. We sequenced HBV DNA using MiSeq Illumina with whole genome target enrichment, and analysed to determine the genotype and identify potential TDF RAMs, based on a pre-defined list of polymorphisms. Results: Among 66 individuals with chronic HBV, we identified three meeting our phenotypic definition for TDF resistance, of whom two were coinfected with HIV. The sequences grouped as genotypes A1 and D3. In one participant, the consensus HBV sequence had ten polymorphisms that have been described in association with TDF resistance. Significant treatment non-adherence in this individual was unlikely, as HIV RNA was suppressed. TDF RAMs were also present in HBV sequences from the other two participants, but other factors including treatment non-adherence may also have had a role in failure of HBV DNA suppression in these cases. Discussion: Our findings add to the evidence that RAMs in HBV RT can underpin a TDF resistant phenotype. This is the first time these RAMs have been reported from Africa in association with clinical evidence of TDF resistance.

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Lamivudine plus tenofovir combination therapy versus lamivudine monotherapy for HBV/HIV coinfection: a meta-analysis

Cited by 11 publications

References 23 publications

Immunological Efficacy of Tenofovir Disproxil Fumarate-Containing Regimens in Patients With HIV-HBV Coinfection: A Systematic Review and Meta-Analysis

Immunological Efficacy of Tenofovir Disproxil Fumarate-Containing Regimens in Patients With HIV-HBV Coinfection: A Systematic Review and Meta-Analysis

FDA approved drugs with pharmacotherapeutic potential for SARS-CoV-2 (COVID-19) therapy

Evidence of Tenofovir Resistance in Chronic Hepatitis B Virus (HBV) Infection: An Observational Case Series of South African Adults

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