Which of the following is recommended as a dual-active drug targeting both HBV and HIV?
Correct Answer: Tenofovir
Description: Tenofovir is a recommended dual-active drug with sufficient activity in targetting both HBV and HIV. Among the Antiretroviral Drugs, Tenofovir (TDF/TAF), Laminvudine (3TC) and Emtricitabine (FTC) have sufficient activity against HBV. Entecavir is an HBV nucleoside analog that only weak/paial HIV activity and is not preferred for use against HIV as it can induce HIV resistance. Designated drugs that have sufficient dual-activity against both HIV and HBV, and hence should be used in HBV-HIV-Co-Infected persons to provide effective treatment also against HIV: Emtrictrabine(FTC) Lamivudine(3TC) Tenofovir (Tenofovir Disoproxil Fumarate (TDF) and Tenofovir Alfenamide (TAF) Entecavir (+/-) TAF is a Tenofovir prodrug with HBV activity and potentially less renal and bone toxicities than TDF. Entecavir: Entecavir is a guanosine analogue that is highly potent against HBV and has weak/paial activity against HIV. It is typically not preferred for use against HIV as it can induce HIV Resistance. When Entecavir is used to treat HBV in patients with HBV/HIV coinfection who are not on A, the drug may select for the M184V mutation that confers HIV resistance to 3TC and FTC. Therefore, Entecavir should only be used in HBV/HIV coinfected patient in addition to (and should not replace components of) fully suppressive A. It should be used as an add-on-drug to also treat HBV in cases only where the other drugs used in A have insufficient HBV activity. Ref: Goodman and Gilman 13th edition
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Pharmacology
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