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Entecavir monotherapy was previously indicated for hepatitis B virus (HBV) infection in HIV-coinfected patients who did not qualify for potent antiretroviral therapy. However, preliminary case reports raised concerns about the underlying assumption that entecavir did not inhibit HIV replication (ACC Mar 5 2007), and the U.S. Department of Health and Human Services (DHHS) subsequently revised its guidelines (ACC May 7). Now, investigators have published a report presenting the evidence that mandated the guideline revision.
The report describes three patients with HBV/HIV coinfection who briefly received entecavir monotherapy without receiving other antiretroviral medications. HIV viral loads dropped by about 1 log in each patient, suggesting …