0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Effects of Lamivudine on Replication of Hepatitis B Virus in HIV-Infected Men

Yves Benhamou, MD; Christine Katlama, MD; Francoise Lunel, MD, PhD; Anne Coutellier, MD; Elisabeth Dohin, MD; Nathalie Hamm, BA; Roland Tubiana, MD; Serge Herson, MD; Thierry Poynard, MD, PhD; and Pierre Opolon, MD
[+] Article and Author Information

From the Groupe Hospitalier Pitie-Salpetriere, Paris, France. Acknowledgments: The authors thank Professor Jean Marie Huraux and Lionel Frangeul for virologic support and Professor Marc Gentilini, Professor Francois Bricaire, Dr. Eric Caume, and Dr. Phillipe Mathurin for their assistance. Grant Support: By La Fondation pour la Recherche Medicale. Requests for Reprints: Yves Benhamou, MD, Services d'Hepato-Gastroenterologie, Groupe Hospitalier Pitie-Salpetriere, 47 Boulevard de l'Hopital, 75651 Paris Cedex 13, France. Current Author Addresses: Drs. Benhamou, Poynard, and Opolon: Service d'Hepato-Gastroenterologie, Groupe Hospitalier Pitie-Salpetriere, 47 Boulevard de l'Hopital, 75651 Paris Cedex 13, France.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1996;125(9):705-712. doi:10.7326/0003-4819-125-9-199611010-00001
Text Size: A A A

Background: Therapy for hepatitis B virus (HBV) infection is still unsatisfactory, particularly in patients who are co-infected with the human immunodeficiency virus (HIV). Lamivudine, a retroviral inhibitor, has been shown to have activity against HBV replication in vitro, in animal models, and in studies of immunocompetent persons.

Objective: To assess the efficacy of lamivudine in inhibiting HBV replication during a 12-month period in patients with both HBV and HIV infection.

Design: Prospective, open study.

Setting: University hospital.

Patients: 40 consecutive patients (39 men and 1 woman) infected with both HIV and HBV. All had progressive HIV disease; were refractory to or unable to tolerate therapies other than lamivudine; and received lamivudine, 600 mg/d or 600 mg/d followed by 300 mg/d, as therapy for HIV disease.

Measurements: Serum concentrations of HBV DNA were assessed every 2 months by using molecular hybridization. Polymerase chain reaction (PCR) for HBV DNA was done at baseline and was done at months 2, 6, and 12 only if the HBV DNA concentration was less than 5 pg/mL.

Results: Two groups were retrospectively identified at baseline: patients with high HBV replication (serum HBV DNA concentrations >5 pg/mL) (n = 30) and patients with low HBV replication (serum HBV DNA concentrations <5 pg/mL) (n = 10). After 12 months of treatment, 26 of 27 patients (96.3% [95% CI, 81% to 99.9%]) who had had high HBV replication at baseline had serum HBV DNA concentrations less than 5 pg/mL. However, PCR could still detect HBV DNA in serum in 11.5% (CI, 2% to 30%) of these patients. Among patients who had had low HBV replication at baseline, the results of PCR for serum HBV DNA became negative in the 6 patients who had had a positive result on PCR at baseline. No serious adverse events occurred during treatment.

Conclusion: Although this study was not a randomized, blinded trial, it suggests that lamivudine is active against HBV replication in men infected with both HBV and HIV.

Figures

Grahic Jump Location
Figure 2. Black squares indicate patients with high HBV replication at baseline; black diamonds indicate patients with low HBV replication at baseline. * = Compared with baseline levels in patients with high HBV replication at baseline. † = The mean ±SD of paired differences between alanine aminotransferase values at 12 months and at baseline was 44.4 IU/L (95% CI, 7.2 IU/L to 81.5 IU/L).
Mean alanine aminotransferase levels in patients infected with both the human immunodeficiency virus and hepatitis B virus (HBV) who had high and low HBV replication at baseline.
Grahic Jump Location
Grahic Jump Location
Figure 1. * = Number of patients.
Percentage of patients with high hepatitis B virus (HBV) replication at baseline who had HBV DNA concentrations greater than 5 pg/mL by molecular hybridization before and during lamivudine therapy.
Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)