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Reuters Health Information (2004-01-16): Anti-HBV agent helpful HAART supplement in HIV/HBV coinfection


Anti-HBV agent helpful HAART supplement in HIV/HBV coinfection

Last Updated: 2004-01-16 13:10:23 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Results of a small study of HIV patients with hepatitis B virus (HBV) coinfection show that it is possible to recover some HBV-specific T cell responses by adding a drug with specific anti-HBV activity to highly active antiretroviral therapy [HAART].

Liver-related mortality is a growing problem in the HIV-HBV-coinfected population, researchers from the UK note in the December 15th issue of The Journal of Infectious Diseases. It's recently been shown in HIV-negative, HBV-infected patients that HBV chronicity leads to a reduction in specific T cell responses and that this can be partially overcome by treatment with lamivudine.

In the current study, Dr. Mala K. Maini of University College, London and colleagues followed 5 HIV/HBV-coinfected patients for up to 24 weeks after the start of HAART alone or HAART with the addition of an anti-HBV drug.

Among the four patients demonstrating a reduction in HBV load, three developed "some detectable" HBV-specific T cell responses at several time points following the addition of an anti-HBV agent. One of them "reconstituted functional CD8 cell responses to 3 HBV epitopes on starting a lamivudine-containing treatment regimen," despite having advanced immunosuppression.

In another treated with the novel anti-HBV drug adefovir dipivoxil, a marked reduction in HBV viremia was accompanied by reconstitution of HBV-specific CD4 cell responses to HBcAg and HBsAg.

"This potential to recover T cell responses, which has been thought to be critical for HBV control, provides support for the addition of anti-HBV therapy in the treatment of HIV/HBV-coinfected patients," the investigators conclude.

Summing up, Dr. Maini told Reuters Health that "we are excited by these preliminary data, which now require confirmation in a larger study."

J Infect Dis 2003;188;1815-1819.

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