Tenofovir-Sparing HIV Therapy Carries Underrecognized Hepatitis B Reactivation Risk

This meta-analysis quantifies hepatitis B virus reactivation and new infection rates after tenofovir cessation, giving pharmacists concrete numbers to support monitoring and vaccination decisions during antiretroviral simplification.

📅 Journal publication: Aug 2026 (online Jul 23, 2026) · Last updated: Oct 7, 2026

tenofovirtenofovir disoproxil fumaratetenofovir alafenamidelamivudinecabotegravirrilpivirineHIVhepatitis B virusHBV reactivationantiretroviral therapylong-acting injectable ARTcoinfectionsystematic reviewmeta-analysis Infectious Disease / Antimicrobials

Background Information

Ceasing tenofovir in HIV patients may elevate HBV reactivation risk.

Discontinuing tenofovir in people with HIV can increase the risk of hepatitis B virus (HBV) reactivation and new infections. HBV reactivation occurred at 3.79 per 100 person-years in actively monitored patients compared to 0.35 without monitoring; new infections were 1.63 per 100 person-years. Careful consideration is needed when switching to tenofovir-sparing regimens to prevent HBV-related complications; results highlight the need for more high-quality studies. Stopping tenofovir in HIV patients may lead to significant HBV risks, demanding vigilant monitoring.

📊 Deep Analysis Available

Subscribers get the full breakdown: study design, outcomes, pharmacist implications, clinical pearls, GRADE evidence grade, and a downloadable PDF report.

Subscribe for Full Access →

Authors: Mohareb AM, Phinius B, Anderson M, Lockman S, Bottero J, Yendewa GA, Kim AY, Boyd A

Citation: Mohareb AM, Phinius B, Anderson M, et al. Hepatitis B virus outcomes in people with HIV after cessation of tenofovir-containing antiretroviral therapy: a systematic review and meta-analysis. EClinicalMedicine. 2026;98:104075. doi:10.1016/j.eclinm.2026.104075

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

🎓

Reviewed by a licensed pharmacist

Every analysis is reviewed and approved by a licensed pharmacist before publication, ensuring clinical accuracy and relevance.

Accurate and up-to-date information is our highest priority.

If you spot an error, please suggest a correction. If there is a topic you want covered, tell us and we will look at it.

Suggest a correction Request a topic

Thanks for the feedback!

🔒

Deep Analysis: Subscribers Only

Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.

Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

Want the full analysis?

Subscribe to PharmD Signal for unrestricted access to every deep analysis, plus PDF reports, GRADE evidence grades, and pharmacist implications for every article we publish.

Become a Subscriber →