Interventional, multicenter, open-label, randomized, non-comparative trial evaluating the safety, in terms of HBV virological control, of 2 antiviral treatment relief strategies, in patients co-infected with the HIV-1 and HBV viruses

Prior treatment

• Fibrosis history at stage F3-F4 in pre-therapy evaluated by PBH, fibrotest and/or fibroscan with a value of Elastometry ≥ 9kPa
• Current treatment with chemo- or immunotherapy (including interferon or interleukins)

Other illness

• HIV-2 infection
• Any condition (drug use, neurological, neuropsychiatric, etc.) that, in the judgment of the investigator, may compromise patient compliance and adherence to the protocol
• HIV and/or HBV genotype not compatible with dual therapy DTG-3TC or DRVr-3TC
• Chronic active viral hepatitis C (HCV RNA positive)
• Delta co-infection
• Active opportunistic infection or acute treatment for opportunistic infection

Other

• Pregnant or breastfeeding woman or refusal of contraception
• Major incapacity, legal protection, guardianship or curatorship.
• HBeAg+.
• Alcohol consumption > 14 units/week for women and 21 units/week for men

• HIV-1-HBV co-infection (positive HIV-1 serology associated with 2 positive HBsAg serologies within more than 6 months)
• HIV CV < 50cp/ml for ≥ 2 years (only 1 annual blip allowed if HIV CV < 200cp/ml and previous and subsequent viral loads are undetectable)
• HBV CV < 10 IU/ml for ≥ 2 years (only 1 annual blip allowed if HBV CV < 200IU/ml and if previous and subsequent viral loads are undetectable)
• Have ≥ 3 available measurements of HIV CV < 50cp/ml and HBV CV < 10 IU/mL over the past 30 months (including that of pre-inclusion
• CD4 lymphocytes > 250/mm3 at pre-inclusion
• Positive Ag HBs HBV serology at pre-inclusion
• ALT < 3N at pre-inclusion
• For women of childbearing potential, negative pregnancy test and commitment to use effective contraception throughout the trial
• Person affiliated with or benefiting from a social security system
• Free, informed, written consent, signed by the person and the investigator at the latest on the day of inclusion and before any examination carried out as part of the study (article L1122-1-1 of the Public Health Code)
• Age ≥ 18 years
• Fibroscan less than 6 months < 9kPa
• Current daily antiretroviral tritherapy not modified for ≥ 12 months must including tenofovir disoproxil fumarate (TDF) 245mg or tenofovir alafenamide fumarate (TAF -25mg) associated to lamivudine (3TC – 300mg) or emtricitabine (FTC - 200mg) and a NNRTI or PI/r or INSTI to choose from o NNRTI = efavirenz, rilpivirine, etravirine, doravirine o PI/r = atazanavir/r ou darunavir/r o INSTI = bictegravir, dolutegravir, elvitegravir/cobicistat, raltegravir
• Absence of documented HBV and HIV genotypic resistance compromising virologic control of any of the maintenance strategies. Patients with no genotypic history may be included)