Hepatitis B Drug a Threat to Those With HIV

Use of Baraclude alone leads AIDS virus to become drug-resistant, study finds.

By E.J. Mundell
HealthDay Reporter
Wednesday, June 20, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

WEDNESDAY, June 20 (HealthDay News) -- Patients infected with both hepatitis B and HIV should not take the hepatitis-fighting drug Baraclude on its own, new research confirms.

The problem is that Baraclude (entecavir) can cause HIV to become resistant to life-extending AIDS medications, according to a study in the June 21 New England Journal of Medicine.

Co-infection with the two sexually transmitted viruses is relatively common -- for example, one 2006 study found that half of HIV-positive American gay men also carry hepatitis B, which is a major cause of fatal liver disease, including liver cancer and cirrhosis. More than 1.2 million Americans are thought to be infected with hepatitis B.

Baraclude, which was first approved to fight hepatitis B in early 2005, does perform well at keeping hepatitis B at bay. But it could also undermine the potency of combination drug therapies in patients who are also HIV-positive, the new study showed.

"This means that if you are going to go ahead and treat for hepatitis B, you better be screening for HIV, too," said Dr. Michael Horberg, director of HIV/AIDS Policy, Quality Improvement and Research at Kaiser Permanente in Santa Clara, Calif. "You can't just say, 'I need to treat the hepatitis B with entecavir, and they'll be fine,' because we now know that that is not the case," said Horberg, who was not involved with the study.

The new findings were first presented in February at the Conference on Retroviruses and Opportunistic Infections in Los Angeles.

Soon after the findings' initial release, Baraclude's maker, Bristol-Myers Squibb, changed the medication's labeling to warn of the potential for HIV drug resistance. The U.S. Department of Health and Human Services also revised its hepatitis B treatment guidelines to warn against using Baraclude as a stand-alone treatment in patients co-infected with HIV who are not yet treated for the latter virus.

According to experts, the findings are not a huge surprise, since other drugs used to suppress hepatitis B are also known to effect changes in HIV.