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Persistent HBV viral load
May 6, 2012

I am a 52 year old black man, HIV & HBV+ since 1988-my last labs showed undetectable HIV viral load with 704 t-cells, but my HBV viral load was 300. I get a liver ultra sound at least once a year-always clear. My HIV regimine is Atripla and Isentress. Am I at high risk for HBV complications?

Response from Dr. Holodniy

Given that your HBV viral load is detectable (although at a very low level) while receiving two drugs that are active against HBV (tenofovir and emtricitabine in Atripla), there is a small but real risk of liver disease associated with HBV infection. Most experts believe that the risk of liver disease progression is very low with a HBV viral load that low. It's good you are getting screened for liver cancer with an ultrasound yearly. We do see cases occasionally like yours. It is possible that your HBV strain is resistant to the two drugs in Atripla, but your viral load is likely too low to get the test. There are other HBV active drugs that can be added to your regimen, but they may or may not work and/or get rid of the HBV infection. You may want to consult with a liver specialist



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