Abstract
Three HIV-infected patients with chronic hepatitis B (genotype A) were switched to adefovir therapy after unsuccessful lamivudine treatment. Surprisingly, adefovir therapy failed, although none of the virus isolates displayed mutations known to be associated with adefovir resistance (A181V, N236T). In two isolates we identified hepatitis B virus DNA polymerase mutation L217R, in one case we found multiple frameshifts in the same region. In all cases adefovir was replaced by tenofovir, resulting in a significant drop in the viral load.
MeSH terms
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AIDS-Related Opportunistic Infections / drug therapy*
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Adenine / analogs & derivatives*
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Adenine / therapeutic use*
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Adult
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Anti-HIV Agents / therapeutic use*
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Chronic Disease
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DNA-Directed DNA Polymerase / genetics
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HIV Infections / drug therapy*
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Hepatitis B / drug therapy*
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Hepatitis B virus / genetics
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Humans
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Lamivudine / therapeutic use
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Male
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Mutation
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Organophosphonates / therapeutic use*
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Reverse Transcriptase Inhibitors / therapeutic use*
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Tenofovir
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Treatment Outcome
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Viral Load
Substances
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Anti-HIV Agents
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Organophosphonates
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Reverse Transcriptase Inhibitors
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Lamivudine
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adefovir
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Tenofovir
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DNA-Directed DNA Polymerase
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Adenine