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Researchers evaluated the additional effect of tenofovir (Viread) on hepatitis B virus (HBV) viral dynamics after HBV DNA breakthrough during lamivudine (Epivir-HBV) therapy.

Eleven chronic HBV patients (five HIV coinfected) with breakthrough HBV DNA and the presence of a YMDD mutation received “add-on” tenofovir 300 mg once daily, while maintaining their existing therapy, including lamivudine.

Sequential sera, taken at day 1; t=0 and t=8 hours, day 2, 4, 7, 10, 14, 21, 28 and thereafter every 4 weeks, were tested for HBV DNA using PCR. Mean baseline log HBV DNA was 8.31 +/- 1.07 (median 8.62; range 6.48-9.76 log HBV DNA).

Application of tenofovir resulted in a mean log HBV DNA decline of 2.54 +/- 0.91 after 4 weeks of tenofovir treatment and a mean decline of 4.95 +/- 0.90 log HBV DNA after 24 weeks of treatment.

The authors conclude: “These data show that tenofovir is capable of blocking viral replication in patients with lamivudine induced mutant viruses in HBV patients as well as in HBV/HIV co-infected patients.”

Ref: de Man RA et al. Viral dynamics with frequent sampling during tenofovir therapy in patients with lamivudine-resistant hepatitis B virus mutants. Abstract 427. 39th EASL, 14-18 April 2004, Berlin, Germany.

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