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Audsley J, et al.
(#63)
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Background
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Entecavir (ETV) is a
guanosine analogue approved for the treatment of HBV and possesses in vitro
anti-HBV and anti-HIV activity.
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Entecavir has been
previously described to induce a key mutation (M184V) associated with
resistance to NRTIs approved for the treatment of HIV.
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Methods
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The objective was to
further characterize entecavir’s anti-HIV activity and to determine risk
factors associated with development of the M184V mutation.
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HIV RNA viral load,
HBV DNA viral loads, HIV polymerase sequencing and other clinical data was
abstracted from the medical records from July 2004 and while receiving
entecavir monotherapy (until July 2007).
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Results
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A median 1 log10
reduction in HIV RNA viral load (range 0.5 – 2) after a median of 113 days
(17 – 291) of entecavir monotherapy occurred in ART-naïve patients.
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A median 1.1 log10
reduction in HIV RNA viral load (range 0.1 – 2.3) after a median of 96 days
(range 75 – 215) of entecavir monotherapy occurred in ART-naïve patients.
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12 of 17 HBV/HIV
patients who received ETV monotherapy demonstrated a 0.5 log10 reduction in
HIV RNA VL or greater, including 7 of the 10 ART naïve patients and 5 of the
7 ART-experienced patients.
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4 patients had a
rebound of HIV RNA VL of 0.5 log10 or greater after achieving a nadir HIV RNA
VL.
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The graphic on the
bottom left of the slide depicts the rates of M184V development.
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Conclusions
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ETV monotherapy
resulted in clinically significant reduction in HIV RNA in the majority of
patients and can select for the M184V mutation.
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ETV should not be
used as monotherapy in HIV/HBV co-infected patients.
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