The HBV Drug Entecavir Effects on HIV-1 Replication and Resistance
Moira A. McMahon, B.S., Benjamin L. Jilek, B.S., Timothy P. Brennan, M.S., Lin Shen, M.D., Yan Zhou, Ph.D., Megan Wind-Rotolo, Ph.D., Sifei Xing, B.S., Shridhar Bhat, Ph.D., Braden Hale, M.D., Robert Hegarty, M.S.N., Curtis R. Chong, M.Phil., Jun O. Liu, Ph.D., Robert F. Siliciano, M.D., Ph.D., and Chloe L. Thio, M.D.
Entecavir, a drug approved by the Food and Drug Administrationfor the treatment of chronic hepatitis B virus (HBV) infection,is not believed to inhibit replication of human immunodeficiencyvirus type 1 (HIV-1) at clinically relevant doses. We observedthat entecavir led to a consistent 1-log10 decrease in HIV-1RNA in three persons with HIV-1 and HBV coinfection, and weobtained supportive in vitro evidence that entecavir is a potentpartial inhibitor of HIV-1 replication. Detailed analysis showedthat in one of these patients, entecavir monotherapy led toan accumulation of HIV-1 variants with the lamivudine-resistantmutation, M184V. In vitro experiments showed that M184V confersresistance to entecavir. Until more is known about HIV-1–resistancepatterns and their selection by entecavir, caution is neededwith the use of entecavir in persons with HIV-1 and HBV coinfectionwho are not receiving fully suppressive antiretroviral regimens.
Source Information
From the Departments of Pharmacology and Molecular Sciences (M.A.M., L.S., S.X., S.B., C.R.C., J.O.L.) and Medicine (B.L.J., T.P.B., Y.Z., M.W.-R., R.H., R.F.S., C.L.T.), Johns Hopkins University School of Medicine; and the Howard Hughes Medical Institute (R.F.S.) — both in Baltimore; and the Division of Infectious Diseases, Naval Medical Center, San Diego, San Diego, CA (B.H.).
Address reprint requests to Dr. Thio at the Department of Medicine, Johns Hopkins University School of Medicine, 1503 E. Jefferson St., Baltimore, MD 21231, or at cthio{at}jhmi.edu.
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