PT  - JOURNAL ARTICLE
AU  - Lumley, Sheila
AU  - Barlow, Maeve
AU  - Said, Khadija
AU  - Martyn, Emily
AU  - Waddilove, Elizabeth
AU  - Delphin, Marion
AU  - Jennings, Daisy
AU  - Chai, Haiting
AU  - Kemper, Agnes
AU  - Ko, Joy
AU  - Ansari, Azim
AU  - Macdonald, Douglas
AU  - Ghosh, Indrajit
AU  - Ijaz, Samreen
AU  - Flanagan, Stuart
AU  - Matthews, Philippa Clare
TI  - Multiple risk factors for persistent HBV viraemia in an adult receiving nucleos/tide analogue therapy
AID  - 10.1136/sextrans-2024-056168
DP  - 2024 Aug 01
TA  - Sexually Transmitted Infections
PG  - 329--331
VI  - 100
IP  - 5
4099  - http://sti.bmj.com/content/100/5/329.short
4100  - http://sti.bmj.com/content/100/5/329.full
SO  - Sex Transm Infect2024 Aug 01; 100
AB  - Diagnosing and treating chronic hepatitis B virus (HBV) infection are key interventions to support progress towards elimination of viral hepatitis by 2030. Although nucleos/tide analogue (NA) therapy is typically highly effective, challenges remain for viral load (VL) suppression, including medication access, incomplete adherence and drug resistance. We present a case of a long-term HBV and HIV coinfected adult prescribed with sequential NA therapy regimens, with episodes of breakthrough viraemia. Multiple factors contribute to virological breakthrough, including exposure to old NA agents, initial high HBV VL, therapy interruptions, intercurrent illnesses and potential contribution from resistance mutations. The case underscores the importance of individualised treatment approaches and adherence support in achieving HBV suppression. Furthermore, it emphasises the need for improved clinical pathways addressing education, support and access to care, particularly for marginalised populations. Comprehensive data collection inclusive of under-represented individuals is crucial for maintaining retention in the care cascade and informing effective interventions.