Evolution of lamivudine-resistant hepatitis B virus and HIV-1 in co-infected individuals: an analysis of the CAESAR study
Evolution of lamivudine-resistant hepatitis B virus and HIV-1 in co-infected individuals: an analysis of the CAESAR study
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拉米夫定耐药乙型肝炎病毒和 HIV-1 在共同感染者中的演变：CAESAR 研究分析
DOI：
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
David Cooper
中科院分区：
文献类型：
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作者：
D. Pillay;P. Cane;D. Ratcliffe;M. Atkins;David Cooper
目的拉米夫定具有较强的抗HIV-1和抗B型肝炎病毒（HBV）活性。合并感染这两种病毒是常见的，这可能会影响抗逆转录病毒疗法的选择。对一组接受拉米夫定治疗的合并感染患者进行研究，以评估拉米夫定治疗44-52周后对同一个体内两种病毒群体的不同作用。设计和方法：回顾性病毒学分析一个HIV-1/HBV合并感染的拉米夫定队列，该队列来自一项随机、安慰剂对照的拉米夫定治疗HIV感染的研究，即CAESAR研究。结果13例拉米夫定治疗44-52周后HBV病毒载量> 10000拷贝/ml的患者中，5例出现基因型耐药。 在研究期间，这5例患者中有4例出现病毒复制反弹，其中1例与血清丙氨酸转氨酶升高相关。13名患者中有10名患者的44-52周HIV病毒载量> 1000拷贝/ml，所有这些患者都有HIV逆转录酶M184 V或M184 I突变。 结论：将这些结果外推到人群中，估计拉米夫定治疗的HIV-1/HBV合并感染患者的1年耐药HBV发生率至少为14%。在HBV合并感染患者中，拉米夫定单药治疗的临床和病毒学获益应与潜在的耐药性相平衡。此外，这些数据表明，HIV和HBV耐药性的决定因素是不同的，并且在合并感染的个体中发生HBV和HIV-1的平行进化，而不是共同进化。
ObjectivesLamivudine has potent activity against HIV-1 and hepatitis B virus (HBV). Co-infection with these two viruses is common, and this may therefore influence the choice of antiretroviral therapies. A cohort of co-infected patients treated with lamivudine were studied in order to evaluate the differential effects of lamivudine on the two viral populations within the same individual after 44–52 weeks of therapy. Design and methodsRetrospective virological analysis of an HIV-1/HBV co-infected lamivudine cohort derived from a randomized, placebo-controlled study of lamivudine in HIV infection, the CAESAR study. ResultsFive of thirteen patients with HBV viral load > 10 000 copies/ml after 44–52 weeks of lamivudine therapy had genotypic drug resistance. Four of these five had a rebound of viral replication over the period of study and in one case this was associated with an alanine transaminase serum elevation. Ten of the thirteen patients had a 44–52 week HIV viral load > 1000 copies/ml, all of whom also had HIV reverse transcriptase M184V or M184I mutations. ConclusionsExtrapolating these results to the population yields an estimated 1-year incidence of drug-resistant HBV of at least 14% in lamivudine-treated HIV-1/HBV co-infected patients. The clinical and virological benefit of HBV lamivudine monotherapy in co-infected patients should be balanced against the potential for emergence of drug resistance. Further, these data suggest that the determinants of HIV and HBV drug resistance are different and that parallel evolution, rather than co-evolution of HBV and HIV-1 in co-infected individuals occurs.
影响因子：
158.5
作者：
Dienstag, JL;Schiff, ER;Brown, NA
通讯作者：
Brown, NA
DOI：
10.1073/pnas.88.19.8495
发表时间：
1991-10-01
影响因子：
11.1
作者：
DOONG, SL;TSAI, CH;CHENG, YC
通讯作者：
CHENG, YC