Lamivudine Plus Tenofovir Combination Therapy Versus Lamivudine Monotherapy for HBV/HIV Coinfection: a Meta-analysis

Overview

Journal Virol J

Publisher Biomed Central

Specialty Microbiology

Date 2018 Sep 12

PMID 30201035

Citations 6

Authors

Aoran Luo

Xiaoyan Jiang

Hong Ren

Affiliations

Soon will be listed here.

Abstract

Background: Currently, there is no consensus on the efficacy and safety of lamivudine (LAM) plus tenofovir disoproxil fumarate (TDF) combination therapy versus lamivudine monotherapy in HBV/HIV coinfected patients.

Methods: A comprehensive literature search was performed in English and Chinese databases. Both relevant dichotomous and continuous variables were extracted, and the combined outcomes were expressed as a risk ratio (RR) or a standard mean difference (SMD).

Results: Eleven eligible studies were included in our analysis. For HBV-relevant outcomes, the proportion of patients with undetectable HBV, the rates of serum alanine aminotransferase (ALT) normalization and hepatitis B e antigen (HBeAg) loss were higher in the combination therapy group than the monotherapy group (RR = 1.42, 95% CI: 1.14-1.76, P = 0.002; RR = 1.36, 95% CI: 1.17-1.58, P < 0.0001; RR = 2.74, 95% CI: 1.20-6.22, P = 0.02). In addition, the rate of HIV RNA-negative conversion was higher in the combination therapy group than the monotherapy group (RR = 1.26, 95% CI: 1.11-1.42, P = 0.0003).

Conclusion: LAM plus TDF combination therapy was more efficacious than LAM monotherapy in HBV/HIV coinfected patients. As time passes, this difference becomes more pronounced.

Citing Articles

Antivirals for prevention of hepatitis B virus mother-to-child transmission in human immunodeficiency virus positive pregnant women co-infected with hepatitis B virus.

Ugwu E, Eleje G, Ugwu A, Nwagha U, Ikechebelu J, Umeh U Cochrane Database Syst Rev. 2023; 6:CD013653.

PMID: 37306558 PMC: 10259198. DOI: 10.1002/14651858.CD013653.pub2.

Recent Advances in Hepatitis B Treatment.

Prifti G, Moianos D, Giannakopoulou E, Pardali V, Tavis J, Zoidis G Pharmaceuticals (Basel). 2021; 14(5).

PMID: 34062711 PMC: 8147224. DOI: 10.3390/ph14050417.

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

Drozdzal S, Rosik J, Lechowicz K, Machaj F, Kotfis K, Ghavami S Drug Resist Updat. 2020; 53:100719.

PMID: 32717568 PMC: 7362818. DOI: 10.1016/j.drup.2020.100719.

A long-acting 3TC ProTide nanoformulation suppresses HBV replication in humanized mice.

Wang W, Smith N, Makarov E, Sun Y, Gebhart C, Ganesan M Nanomedicine. 2020; 28:102185.

PMID: 32217146 PMC: 7438263. DOI: 10.1016/j.nano.2020.102185.

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

Jiang T, Su B, Song T, Zhu Z, Xia W, Dai L Front Pharmacol. 2019; 10:1023.

PMID: 31572195 PMC: 6752181. DOI: 10.3389/fphar.2019.01023.

References

Jain M, Comanor L, White C, Kipnis P, Elkin C, Leung K . Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV-coinfected patients: factors associated with response. J Viral Hepat. 2007; 14(3):176-82. DOI: 10.1111/j.1365-2893.2006.00797.x. View

Yao G, Zhu M, Cui Z, Wang B, Yao J, Zeng M . A 7-year study of lamivudine therapy for hepatitis B virus e antigen-positive chronic hepatitis B patients in China. J Dig Dis. 2009; 10(2):131-7. DOI: 10.1111/j.1751-2980.2009.00375.x. View

Begg C, Mazumdar M . Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994; 50(4):1088-101. View

Kang L, Pan J, Wu J, Hu J, Sun Q, Tang J . Anti-HBV Drugs: Progress, Unmet Needs, and New Hope. Viruses. 2015; 7(9):4960-77. PMC: 4584298. DOI: 10.3390/v7092854. View

Li Y, Xie J, Han Y, Wang H, Zhu T, Wang N . Lamivudine Monotherapy-Based cART Is Efficacious for HBV Treatment in HIV/HBV Coinfection When Baseline HBV DNA <20,000 IU/mL. J Acquir Immune Defic Syndr. 2016; 72(1):39-45. PMC: 4977191. DOI: 10.1097/QAI.0000000000000927. View

Garvey L, Curtis H, Brook G . The British HIV Association national audit on the management of subjects co-infected with HIV and hepatitis B/C. Int J STD AIDS. 2011; 22(3):173-6. DOI: 10.1258/ijsa.2010.010380. View

Gracey D, Snelling P, Mckenzie P, Strasser S . Tenofovir-associated Fanconi syndrome in patients with chronic hepatitis B monoinfection. Antivir Ther. 2013; 18(7):945-8. DOI: 10.3851/IMP2649. View

Alter M . Epidemiology of viral hepatitis and HIV co-infection. J Hepatol. 2005; 44(1 Suppl):S6-9. DOI: 10.1016/j.jhep.2005.11.004. View

Guettouche T, Hnatyszyn H . Chronic hepatitis B and viral genotype: the clinical significance of determining HBV genotypes. Antivir Ther. 2005; 10(5):593-604. View

10.

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

11.

Wang S, Chen P, Yeh S . Gender disparity in chronic hepatitis B: Mechanisms of sex hormones. J Gastroenterol Hepatol. 2015; 30(8):1237-45. DOI: 10.1111/jgh.12934. View

12.

Lai C, Dienstag J, Schiff E, Leung N, Atkins M, Hunt C . Prevalence and clinical correlates of YMDD variants during lamivudine therapy for patients with chronic hepatitis B. Clin Infect Dis. 2003; 36(6):687-96. DOI: 10.1086/368083. View

13.

Brook G, Main J, Nelson M, Bhagani S, Wilkins E, Leen C . British HIV Association guidelines for the management of coinfection with HIV-1 and hepatitis B or C virus 2010. HIV Med. 2010; 11(1):1-30. DOI: 10.1111/j.1468-1293.2009.00781.x. View

14.

Kao J, Liu C, Chen D . Hepatitis B viral genotypes and lamivudine resistance. J Hepatol. 2002; 36(2):303-4. DOI: 10.1016/s0168-8278(01)00246-x. View

15.

Westland C, Delaney 4th W, Yang H, Chen S, Marcellin P, Hadziyannis S . Hepatitis B virus genotypes and virologic response in 694 patients in phase III studies of adefovir dipivoxil1. Gastroenterology. 2003; 125(1):107-16. DOI: 10.1016/s0016-5085(03)00700-5. View

16.

Galbraith R . A note on graphical presentation of estimated odds ratios from several clinical trials. Stat Med. 1988; 7(8):889-94. DOI: 10.1002/sim.4780070807. View

17.

Price H, Dunn D, Pillay D, Bani-Sadr F, de Vries-Sluijs T, Jain M . Suppression of HBV by tenofovir in HBV/HIV coinfected patients: a systematic review and meta-analysis. PLoS One. 2013; 8(7):e68152. PMC: 3707972. DOI: 10.1371/journal.pone.0068152. View

18.

Casado J . Renal and Bone Toxicity with the Use of Tenofovir: Understanding at the End. AIDS Rev. 2016; 18(2):59-68. View

19.

Avihingsanon A, Lewin S, Kerr S, Chang J, Piyawat K, Napissanant N . Efficacy of tenofovir disoproxil fumarate/emtricitabine compared with emtricitabine alone in antiretroviral-naive HIV-HBV coinfection in Thailand. Antivir Ther. 2010; 15(6):917-22. DOI: 10.3851/IMP1645. View

20.

Zampino R, Boemio A, Sagnelli C, Alessio L, Adinolfi L, Sagnelli E . Hepatitis B virus burden in developing countries. World J Gastroenterol. 2015; 21(42):11941-53. PMC: 4641116. DOI: 10.3748/wjg.v21.i42.11941. View