Circulation of HBV encoding envelope mutations with diminished HBs antigen-antibody binding as result of selection of drug-resistance mutations may occur, particularly in patients infected with HBV genotype A, the most prevalent genotype among HBV/HIV-coinfected patients. Such mutations might represent a public health concern because of the potential risk of transmission of HBV drug- and vaccine-resistant strains.
Risk transmission group, age, and positive serum HBeAg are the main determinants of distinct HBV virologic variants, including HBV genotypes and LAM-resistant mutants, in HBV/HIV-coinfected patients.
ATV is relatively safe and provides significant virological response in PI-experienced patients, mainly among those with a low number of protease resistance mutations. The GIQ predicts accurately the virological response in patients receiving ATV. Hyperbilirubinemia is associated with higher ATV plasma levels.
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