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Widely used hepatitis B drug spurs HIV drug resistance

A Johns Hopkins study has proven false established medical practice that an antiretroviral drug widely used to treat hepatitis B liver infections was safe to use on its own in patients co-infected with HIV. Their findings demonstrate that treatment with entecavir leads to cross-resistance to other antiviral drugs used to treat the AIDS virus.

"Our results show that entecavir is no different from any other that has been shown to be active against HIV - it breeds resistance rapidly, despite its ability to reduce the amount of HIV in the body," says senior study author and infectious disease specialist Chloe Thio, M.D.

Researchers say the findings, to be presented Feb. 28 at the 2007 Conference on Retroviruses and Opportunistic Infections (CROI) in Los Angeles, have serious implications for the more than 4 million people worldwide believed to be infected with both viral illnesses but who need to treat their hepatitis B and are not yet on anti-HIV drugs.

Authors of the study have informed the U.S. Food and Drug Administration of their results so that prescribing physicians can be notified and so that drug labeling can be changed. They have also notified Bristol-Myers Squibb, which makes and sells entecavir under the brand name Baraclude.

"The alert should go out to co-infected people to consult with their physicians immediately about entecavir to see if it is the right drug to treat their hepatitis B in the first place and to evaluate alternative therapies," says Thio, an associate professor of medicine at The Johns Hopkins University School of Medicine.

Thio says she has stopped prescribing entecavir as her first option in treating hepatitis B in co-infected patients who are not already using drugs to suppress HIV.

"The good news is that co-infected patients already on HIV therapy can still use entecavir to treat their hepatitis B, but the bad news is that there are now fewer options for treating hepatitis
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Source:Johns Hopkins Medical Institutions


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