• Moira A McMahon, Benjamin L Jilek, Timothy P Brennan, Lin Shen, Yan Zhou, Megan Wind-Rotolo, Sifei Xing, Shridhar Bhat, Braden Hale, Robert Hegarty, Curtis R Chong, Jun O Liu, Robert F Siliciano, and Chloe L Thio.
• Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.
• N. Engl. J. Med. 2007 Jun 21; 356 (25): 2614-21.

AbstractEntecavir, a drug approved by the Food and Drug Administration for the treatment of chronic hepatitis B virus (HBV) infection, is not believed to inhibit replication of human immunodeficiency virus type 1 (HIV-1) at clinically relevant doses. We observed that entecavir led to a consistent 1-log(10) decrease in HIV-1 RNA in three persons with HIV-1 and HBV coinfection, and we obtained supportive in vitro evidence that entecavir is a potent partial inhibitor of HIV-1 replication. Detailed analysis showed that in one of these patients, entecavir monotherapy led to an accumulation of HIV-1 variants with the lamivudine-resistant mutation, M184V. In vitro experiments showed that M184V confers resistance to entecavir. Until more is known about HIV-1-resistance patterns and their selection by entecavir, caution is needed with the use of entecavir in persons with HIV-1 and HBV coinfection who are not receiving fully suppressive antiretroviral regimens.Copyright 2007 Massachusetts Medical Society.

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