New evidence supports safety of tenofovir-sparing ART in HBV-immune people with HIV
Emerging data presented at the 2025 European AIDS Clinical Society (EACS) Congress suggest that stopping tenofovir in people with HIV who have prior hepatitis B exposure poses a very small risk of hepatitis B virus (HBV) reactivation. The findings come from the Swiss HIV Cohort Study, which analyzed HBV markers in individuals who had become virologically suppressed on tenofovir-containing regimens and then transitioned to regimens without HBV-active drugs.
Who was studied and how the analysis was performed
The study included 380 participants who discontinued tenofovir after a median of 4.5 years on therapy. All were HBV surface antigen (HBsAg)-negative but core antibody (HBcAb)-positive, indicating past exposure to HBV rather than chronic infection. Participants were matched 1:1 by age, sex, and duration on tenofovir into two groups: those who switched to non-XTC (non-lamivudine or non-emtricitabine) regimens and those who stayed on XTC-containing ART, which includes agents with activity against HBV.
