Efficacy and safety of therapy of chronic hepatitis B with telbivudine (LdT) in patients with HIV-infection without HAART

Introduction

According to the European recommendations (version 5.2., November 2009) at patients with the HIV-infection and chronic hepatitis B (CHB), not receiving HAART, adefovir and LdT may be used as an alternative regime. In the Russian Federation adefovir is not registered and tenofovir was registered only in March 2010.

Objective

To study efficacy and safety Ltd at patients with HIV-infection and CHB (HIV/CHB).

Methods

12 patients with HIV/CHB (men 10), middle age of 33,5 years, without HAART (CD4 + - 450-650 cells/mm3), since 2009 received LdT (600 mg QD). All patients had HBsAg, HBV DNA. 9 from 12 patients had HBeAg. Duration of treatment has made 3-12 months.

Summary of results

At all patients had the positive result of therapy with LdT: 7 patients had disappearance of HBV DNA in 1-6 months; at 1 patient after 3 months of therapy observed disappearance of HBsAg and appearance anti-HBs and Ltd has been cancelled. At 5 patients through 6-9 months of treatment is marked a decreasing of level of HBV DNA on 2-3 log IU/ml. At 4 from 9 patients with HBeAg observed seroconversion to anti-HBe. In absence HAART registered fluctuations of level of HIV RNA was not statistically significant. The adverse events of therapy with Ltd have not been registered.

Conclusions

Therapy of CHB with Ltd at patients with HIV-infection was effective: at 58,3 % of patients had disappearance of HBV DNA, and at 4 from 9 patients with HBeAg observed seroconversion. Influence of therapy with Ltd on dynamics of HIV RNA it wasn’t revealed.