Tenofovir in HIV/HBV Coinfection

Inclusion Criteria: * Written informed consent * Documented HIV infection (positive serology for HIV-1 and detectable HIV-1 RNA) * Age 18 - 70 years * HBV DNA \> 105 copies/ml * HBsAg positive \>6 months or HBsAg positive and anti HB core IgM negative * Creatinine \<= 2.0mg/dl (\<= 0.2 mmol/L) * Platelet count \>= 50,000/mm * HIV-1 antiretroviral therapy naïve * No prior exposure to anti-HBV agents (LAM, adefovir, TDF) although prior IFN treatment allowed Exclusion Criteria: * HCV-RNA positive or Anti-HAV IgM positive * Acute hepatitis (serum ALT \> 1000 U/L) * Active opportunistic infection * Other causes of chronic liver disease identified (autoimmune hepatitis, hemochromatosis, Wilsons disease, alfa-1-antitrypsin deficiency) * Concurrent malignancy requiring cytotoxic chemotherapy * Decompensated or Child's C cirrhosis * Alfa-fetoprotein (AFP) \> 3X ULN (unless negative CT scan or MRI within 3 months of entry date) * Pregnancy or lactation * Any other condition which in the opinion of the investigator might interfere with compliance or outcome of the study