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HIV With Hepatitis B CoinfectionOctober 2023

What the ALLIANCE Trial Found — Bictegravir Combo for HIV-Hepatitis B Coinfection

ALLIANCE compared two HIV pills — bictegravir/emtricitabine/tenofovir alafenamide and dolutegravir/emtricitabine/tenofovir disoproxil — in 243 adults with both HIV and hepatitis B. Both suppressed HIV equally well; the bictegravir combo suppressed hepatitis B faster.

What the trial was testing

The ALLIANCE enrolled 244 patients with hiv with hepatitis b coinfection. The study was sponsored by Gilead Sciences and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

63% had hepatitis B suppression at 48 weeks on the bictegravir combo vs. 43%.

The Lancet HIV · 2023 · NCT03547908

These findings — that hepatitis B suppression at 48 weeks on the bictegravir combo vs. dolutegravir combo — were published in the The Lancet HIV and represent the headline result of the study.

Researchers tracked outcomes across 244 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with hiv with hepatitis b coinfection, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy) is FDA-approved and available now for HIV. This trial supports it as a strong choice for people with both HIV and chronic hepatitis B. Ask an HIV specialist if it fits your situation.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.