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Published in: Virology Journal 1/2018

Open Access 01-12-2018 | Research

Lamivudine plus tenofovir combination therapy versus lamivudine monotherapy for HBV/HIV coinfection: a meta-analysis

Authors: Aoran Luo, Xiaoyan Jiang, Hong Ren

Published in: Virology Journal | Issue 1/2018

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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.
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Literature
1.
go back to reference Alter MJ. Epidemiology of viral hepatitis and HIV co-infection. J Hepatol. 2006;44:6–9.CrossRef Alter MJ. Epidemiology of viral hepatitis and HIV co-infection. J Hepatol. 2006;44:6–9.CrossRef
3.
go back to reference Diederich WE, Steuber H. Therapy of viral infections. Topics Med Chem. 2015;2:35–56. Diederich WE, Steuber H. Therapy of viral infections. Topics Med Chem. 2015;2:35–56.
4.
go back to reference Fischer J. Analogue-based drug discovery. Chemistry International -- Newsmagazine for IUPAC. 2010;32:12–5. Fischer J. Analogue-based drug discovery. Chemistry International -- Newsmagazine for IUPAC. 2010;32:12–5.
5.
go back to reference Sharp M, Interpharma D, Sharp M, Interpharma D, Celle L, Cloud S. Sharp M. WHO Model List of Essential Medicines: Interpharma D; 2011. Sharp M, Interpharma D, Sharp M, Interpharma D, Celle L, Cloud S. Sharp M. WHO Model List of Essential Medicines: Interpharma D; 2011.
6.
go back to reference Brook G, Main J, Nelson M, Bhagani S, Wilkins E, Leen C, Fisher M, Gilleece Y, Gilson R, Freedman A. British HIV association guidelines for the management of coinfection with HIV-1 and hepatitis B or C virus 2010. Hiv Med. 2010;11:1–30.CrossRefPubMed Brook G, Main J, Nelson M, Bhagani S, Wilkins E, Leen C, Fisher M, Gilleece Y, Gilson R, Freedman A. British HIV association guidelines for the management of coinfection with HIV-1 and hepatitis B or C virus 2010. Hiv Med. 2010;11:1–30.CrossRefPubMed
7.
go back to reference Zampino R, Boemio A, Sagnelli C, Alessio L, Adinolfi LE, Sagnelli E, Coppola N. Hepatitis B virusburden in developing countries. World J Gastroentero. 2015;21:11941.CrossRef Zampino R, Boemio A, Sagnelli C, Alessio L, Adinolfi LE, Sagnelli E, Coppola N. Hepatitis B virusburden in developing countries. World J Gastroentero. 2015;21:11941.CrossRef
8.
go back to reference Stabinski L, Barnhart M, Kahn RJ, Hamm TE. Prevalence of HIV and hepatitis B virus co-infection in sub-Saharan Africa and the potential impact and program feasibility of hepatitis B surface antigen screening in resource-limited settings. J Acquir Immune Defic Syndr. 2015;3:274–85.CrossRef Stabinski L, Barnhart M, Kahn RJ, Hamm TE. Prevalence of HIV and hepatitis B virus co-infection in sub-Saharan Africa and the potential impact and program feasibility of hepatitis B surface antigen screening in resource-limited settings. J Acquir Immune Defic Syndr. 2015;3:274–85.CrossRef
9.
go back to reference Price H, Dunn D, Pillay D, Banisadr F, Vriessluijs TD, Jain MK, Kuzushita N, Mauss S, Núñez M, Nüesch R. Suppression of HBV by Tenofovir in HBV/HIV Coinfected patients: a systematic review and meta-analysis. PLoS One. 2013;8:e68152.CrossRefPubMedPubMedCentral Price H, Dunn D, Pillay D, Banisadr F, Vriessluijs TD, Jain MK, Kuzushita N, Mauss S, Núñez M, Nüesch R. Suppression of HBV by Tenofovir in HBV/HIV Coinfected patients: a systematic review and meta-analysis. PLoS One. 2013;8:e68152.CrossRefPubMedPubMedCentral
10.
go back to reference Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088.CrossRefPubMed Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088.CrossRefPubMed
11.
go back to reference Stuck AE, Rubenstein LZ, Wieland D, Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. 1998;316:469–77. Stuck AE, Rubenstein LZ, Wieland D, Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. 1998;316:469–77.
12.
go back to reference Jain MK, Comanor L, White C, Kipnis P, Elkin C, Leung K, Ocampo A, Attar N, Keiser P, Lee WM. Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV-coinfected patients: factors associated with response. J Viral Hepatitis. 2010;14:176–82.CrossRef Jain MK, Comanor L, White C, Kipnis P, Elkin C, Leung K, Ocampo A, Attar N, Keiser P, Lee WM. Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV-coinfected patients: factors associated with response. J Viral Hepatitis. 2010;14:176–82.CrossRef
13.
go back to reference Li Y, Xie J, Han Y, Wang H, Zhu T, Wang N, Lv W, Guo F, Qiu Z, Li Y, et al. 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;72:39–45.CrossRefPubMedPubMedCentral Li Y, Xie J, Han Y, Wang H, Zhu T, Wang N, Lv W, Guo F, Qiu Z, Li Y, et al. 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;72:39–45.CrossRefPubMedPubMedCentral
14.
go back to reference Wang L, Wiener J, Bulterys M, Wei X, Chen L, Liu W, Liang S, Shepard C, Wang L, Wang A. Hepatitis B virus (HBV) load response to 2 antiviral regimens, Tenofovir/lamivudine and lamivudine, in HIV/ HBV-Coinfected pregnant women in Guangxi, China: the Tenofovir in pregnancy (TiP) study. J Infect Dis. 2016;214:1695.CrossRefPubMed Wang L, Wiener J, Bulterys M, Wei X, Chen L, Liu W, Liang S, Shepard C, Wang L, Wang A. Hepatitis B virus (HBV) load response to 2 antiviral regimens, Tenofovir/lamivudine and lamivudine, in HIV/ HBV-Coinfected pregnant women in Guangxi, China: the Tenofovir in pregnancy (TiP) study. J Infect Dis. 2016;214:1695.CrossRefPubMed
15.
go back to reference Chen J-r. Clinical efficacy of tenofovir disoproxil combined with lamivudine in treating HIV with hepatitis B virus infected. Chin J of Clinical Rational Drug Use. 2017;10:21–2. [in Chinese] Chen J-r. Clinical efficacy of tenofovir disoproxil combined with lamivudine in treating HIV with hepatitis B virus infected. Chin J of Clinical Rational Drug Use. 2017;10:21–2. [in Chinese]
16.
go back to reference Chen R-f, Zheng Y-f, Xu S-f, Yang Q-e, Lu Y-h, Jiang Y-m. A 72-week on-treatment efficacy of de novo combination of tenofovir plus lamivudine based highly active antiretroviral therapy for HBV-HIV coinfected patients. Chinese Journal of Clinical Infectious Diseases. 2013;6:153–6. [in Chinese] Chen R-f, Zheng Y-f, Xu S-f, Yang Q-e, Lu Y-h, Jiang Y-m. A 72-week on-treatment efficacy of de novo combination of tenofovir plus lamivudine based highly active antiretroviral therapy for HBV-HIV coinfected patients. Chinese Journal of Clinical Infectious Diseases. 2013;6:153–6. [in Chinese]
17.
go back to reference Gao H-g. Tenofovir and Lamivudine in Treatment of AIDS Complicated with Hepatitis B Virus Infection. System Medicine. 2016;1:54–6. [in Chinese] Gao H-g. Tenofovir and Lamivudine in Treatment of AIDS Complicated with Hepatitis B Virus Infection. System Medicine. 2016;1:54–6. [in Chinese]
18.
go back to reference He Z-y. The clinical efficacy and safety of hepatitis B virus infection patients combined with acquired immune deficiency syndrome treated by tenofovir disoproxil combined lamivudine. Chinese Journal of Experimental and Clinical Infectious Diseases: Electronic Edition. 2015;9:100–2. [in Chinese] He Z-y. The clinical efficacy and safety of hepatitis B virus infection patients combined with acquired immune deficiency syndrome treated by tenofovir disoproxil combined lamivudine. Chinese Journal of Experimental and Clinical Infectious Diseases: Electronic Edition. 2015;9:100–2. [in Chinese]
19.
go back to reference Liu S-x. Observation of the efficacy of tenofovir combined with lamivudine in the treatment of AIDS with hepatitis B virus for 72 weeks. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2017;26:992–4. [in Chinese] Liu S-x. Observation of the efficacy of tenofovir combined with lamivudine in the treatment of AIDS with hepatitis B virus for 72 weeks. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2017;26:992–4. [in Chinese]
20.
go back to reference Luo J-f, Chen B, Yang S-x, Liu H-s, Hu Y-S, Lai Z-H, et al. Clinical observation of antiviral therapy against HIV infection with chronic hepatitis B virus infection. Contemporary Medicine. 2016;22:146–7. [in Chinese] Luo J-f, Chen B, Yang S-x, Liu H-s, Hu Y-S, Lai Z-H, et al. Clinical observation of antiviral therapy against HIV infection with chronic hepatitis B virus infection. Contemporary Medicine. 2016;22:146–7. [in Chinese]
21.
go back to reference Zhou M. Therapeutic effect and safety analysis of tenofovir dipivoxil combined with lamivudine and efavirenz on HIV/HBV coinfection. Med. Inf. 2016;29:50–1. [in Chinese] Zhou M. Therapeutic effect and safety analysis of tenofovir dipivoxil combined with lamivudine and efavirenz on HIV/HBV coinfection. Med. Inf. 2016;29:50–1. [in Chinese]
22.
go back to reference Zhou Y. Effect of tenofovir dipivoxil combined with lamivudine in the treatment of AIDS complicated with hepatitis B virus infection. Henan Medical Research. 2016;25:746–7. [in Chinese] Zhou Y. Effect of tenofovir dipivoxil combined with lamivudine in the treatment of AIDS complicated with hepatitis B virus infection. Henan Medical Research. 2016;25:746–7. [in Chinese]
23.
go back to reference Avihingsanon A, Lewin SS, Chang JJ, Piyawat K, Napissanant N, Matthews GV, Dore GJ, Bowden S, Lange J, Ruxrungtham K. Efficacy of tenofovir disoproxil fumarate/emtricitabine compared with emtricitabine alone in antiretroviral-naive HIV-HBV coinfection in Thailand. Antivir Ther. 2010;15:917.CrossRefPubMed Avihingsanon A, Lewin SS, Chang JJ, Piyawat K, Napissanant N, Matthews GV, Dore GJ, Bowden S, Lange J, Ruxrungtham K. Efficacy of tenofovir disoproxil fumarate/emtricitabine compared with emtricitabine alone in antiretroviral-naive HIV-HBV coinfection in Thailand. Antivir Ther. 2010;15:917.CrossRefPubMed
24.
go back to reference 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;22:173–6.CrossRefPubMed 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;22:173–6.CrossRefPubMed
25.
go back to reference Kao JH, Liu CJ, Chen DS. Hepatitis B viral genotypes and lamivudine resistance. J Hepatol. 2002;36:303–4.CrossRefPubMed Kao JH, Liu CJ, Chen DS. Hepatitis B viral genotypes and lamivudine resistance. J Hepatol. 2002;36:303–4.CrossRefPubMed
26.
go back to reference Westland C, Delaney WT, Yang H, Chen SS, Marcellin P, Hadziyannis S, Gish R, Fry J, Brosgart C, Gibbs C, et al. Hepatitis B virus genotypes and virologic response in 694 patients in phase III studies of adefovir dipivoxil1. Gastroenterology. 2003;125:107–16.CrossRefPubMed Westland C, Delaney WT, Yang H, Chen SS, Marcellin P, Hadziyannis S, Gish R, Fry J, Brosgart C, Gibbs C, et al. Hepatitis B virus genotypes and virologic response in 694 patients in phase III studies of adefovir dipivoxil1. Gastroenterology. 2003;125:107–16.CrossRefPubMed
27.
go back to reference Guettouche T, Hnatyszyn HJ. Chronic hepatitis B and viral genotype: the clinical significance of determining HBV genotypes. Antivir Ther. 2005;10:593–604.PubMed Guettouche T, Hnatyszyn HJ. Chronic hepatitis B and viral genotype: the clinical significance of determining HBV genotypes. Antivir Ther. 2005;10:593–604.PubMed
28.
go back to reference Lai CL, Dienstag J, Schiff E, Leung NW, Atkins M, Hunt C, Brown N, Woessner M, Boehme R, Condreay L. Prevalence and clinical correlates of YMDD variants during lamivudine therapy for patients with chronic hepatitis B. Clin Infect Dis. 2003;36:687–96.CrossRefPubMed Lai CL, Dienstag J, Schiff E, Leung NW, Atkins M, Hunt C, Brown N, Woessner M, Boehme R, Condreay L. Prevalence and clinical correlates of YMDD variants during lamivudine therapy for patients with chronic hepatitis B. Clin Infect Dis. 2003;36:687–96.CrossRefPubMed
29.
go back to reference Yao GB, Zhu M, Cui ZY, Wang BE, Yao JL, Zeng MD. A 7-year study of lamivudine therapy for hepatitis B virus e antigen-positive chronic hepatitis B patients in China. J Dig Dis. 2009;10:131–7.CrossRefPubMed Yao GB, Zhu M, Cui ZY, Wang BE, Yao JL, Zeng MD. A 7-year study of lamivudine therapy for hepatitis B virus e antigen-positive chronic hepatitis B patients in China. J Dig Dis. 2009;10:131–7.CrossRefPubMed
30.
go back to reference Gracey DM, Snelling P, Mckenzie P, Strasser SI. Tenofovir-associated Fanconi syndrome in patients with chronic hepatitis B monoinfection. Antivir Ther. 2013;18:945.CrossRefPubMed Gracey DM, Snelling P, Mckenzie P, Strasser SI. Tenofovir-associated Fanconi syndrome in patients with chronic hepatitis B monoinfection. Antivir Ther. 2013;18:945.CrossRefPubMed
31.
go back to reference Casado JL. Renal and bone toxicity with the use of Tenofovir: understanding at the end. AIDS Rev. 2016;18:59.PubMed Casado JL. Renal and bone toxicity with the use of Tenofovir: understanding at the end. AIDS Rev. 2016;18:59.PubMed
32.
go back to reference Cochran WG. The combination of estimates from different experiments. Biometrics. 1954;10:101–29.CrossRef Cochran WG. The combination of estimates from different experiments. Biometrics. 1954;10:101–29.CrossRef
33.
go back to reference Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2011;327:557–60.CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2011;327:557–60.CrossRef
34.
go back to reference Galbraith RF. A note on graphical presentation of estimated odds ratios from several clinical trials. Stat Med. 2010;7:889–94.CrossRef Galbraith RF. A note on graphical presentation of estimated odds ratios from several clinical trials. Stat Med. 2010;7:889–94.CrossRef
35.
go back to reference Wang SH, Chen PJ, Yeh SH. Gender disparity in chronic hepatitis B: mechanisms of sex hormones. Journal of Gastroenterology & Hepatology. 2015;30:1237.CrossRef Wang SH, Chen PJ, Yeh SH. Gender disparity in chronic hepatitis B: mechanisms of sex hormones. Journal of Gastroenterology & Hepatology. 2015;30:1237.CrossRef
Metadata
Title
Lamivudine plus tenofovir combination therapy versus lamivudine monotherapy for HBV/HIV coinfection: a meta-analysis
Authors
Aoran Luo
Xiaoyan Jiang
Hong Ren
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Virology Journal / Issue 1/2018
Electronic ISSN: 1743-422X
DOI
https://doi.org/10.1186/s12985-018-1050-3

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