Efficacy of tenofovir alafenamide- or tenofovir disoproxil fumarate-containing regimens in adults with treatment-naïve HIV-hepatitis B co-infection

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Background Hepatitis B (HBV) infection affects 4%–14% of people with HIV infection in Turkey. Tenofovir alafenamide (TAF) is highly effective in treatment of HIV infection. While it is active against HBV, data on the use in HIV-HBV co-infection are limited. Patients and Methods We analyzed the efficacy of tenofovir disoproxil fumarate (TDF)- and TAF-containing regimens in patients with HIV-HBV co-infection from six centers in Istanbul, Turkey. The results of the cohort of 36 months were presented. Results 259 patients were enrolled: 146 and 113 were receiving TAF- and TDF-containing regimens respectively. Baseline characteristics were comparable except TAF-containing group was older; had higher CD4 cell count and lower rate of CD4 count ≤200 cells/μL. Baseline HIV-RNA were 8.2 log copies/mL and 6.8 log in TAF- and TDF-containing groups, respectively ( p = .059) and HBV-DNA levels were 8.1 log IU/mL in both groups. Thirty-eight and 39% of the patients were HBeAg-positive. After 36 months, undetectable HBV-DNA was noted in 88% and 87%, and undetectable HIV-RNA in 85% and in 83% of TAF and TDF-containing groups, respectively. The increase in mean CD4 cell was significant in both groups: Δ = 311 cells/μL in TAF- and Δ = 393 cells/μL in TDF-containing groups. Rates of HBeAg loss (63% vs 57%), HBeAg seroconversion (35% vs 29%), HBsAg loss (29% vs 27%), and HBsAg seroconversion (23% vs 16%) were comparable at 36 months of therapy. Conclusion This real-life study showed that both TAF- and TDF-containing regimens are effective in co-infected patients. The rates of HBsAg loss seemed higher than those in HBV-monoinfected patients.