Acute Hepatitis B Infection After a Switch to Long-Acting Cabotegravir and Rilpivirine

Claire Pintado; Constance Delaugerre; Jean-Michel Molina

doi:10.1093/ofid/ofaa367

Acute Hepatitis B Infection After a Switch to Long-Acting Cabotegravir and Rilpivirine

Open Forum Infect Dis. 2020 Sep 25;7(9):ofaa367. doi: 10.1093/ofid/ofaa367. eCollection 2020 Sep.

Authors

Claire Pintado¹, Constance Delaugerre², Jean-Michel Molina¹

Affiliations

¹ Department of Infectious Diseases, Saint-Louis Hospital, University of Paris Diderot, Paris, France.
² Department of Virology, Saint-Louis Hospital, University of Paris Diderot, Paris, France.

Abstract

Maintenance antiretroviral therapy with combination of two injectable long-acting drugs, cabotegravir and rilpivirine, is a new strategy addressing the challenges of daily adherence to oral pills that has shown non-inferior efficacy to standard of care therapy in patients with suppressed HIV-infection. Patients co-infected with hepatitis B virus (HBV) are not eligible for this dual therapy since it has no activity against HBV, but this strategy should also be restricted to patients with anti-HBs antibodies since people with HIV are still at risk of HBV acquisition due to high risk behavior and since HBV vaccination does not always elicit anti-HBs antibodies, as highlighted in the case report below.

Keywords: Acute hepatitis B; HBV vaccination; Long-acting antiretroviral HIV; cabotegravir; rilpivirine.