RT Journal Article
SR Electronic
T1 Multiple risk factors for persistent HBV viraemia in an adult receiving nucleos/tide analogue therapy
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 329
OP 331
DO 10.1136/sextrans-2024-056168
VO 100
IS 5
A1 Lumley, Sheila
A1 Barlow, Maeve
A1 Said, Khadija
A1 Martyn, Emily
A1 Waddilove, Elizabeth
A1 Delphin, Marion
A1 Jennings, Daisy
A1 Chai, Haiting
A1 Kemper, Agnes
A1 Ko, Joy
A1 Ansari, Azim
A1 Macdonald, Douglas
A1 Ghosh, Indrajit
A1 Ijaz, Samreen
A1 Flanagan, Stuart
A1 Matthews, Philippa Clare
YR 2024
UL http://sti.bmj.com/content/100/5/329.abstract
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.