Efficacy of Tenofovir and Emtricitabine in ARV-naive Patients With HIV/HBV Co-infection

Inclusion Criteria: * Written informed consent * Documented HIV infection (positive serology for HIV-1 and detectable HIV-1 RNA) * Age 18 - 70 years * HBV DNA \> 106 copies/ml * HBsAg positive for \> 6 months In case documented duration of HBsAg seropositive is less than 6 months (this situation is most likely to occur in patients newly presenting to the HIV-outpatient clinic) the patient is eligible if the patient is: 1. HBsAg positive and 2. HBc core IgM antibody negative and 3. the liver biopsy gives evidence for a chronic active hepatitis. Thus making it likely that this patient has acquired the HBV infection more than 6 months ago. * ALT \< 10 x ULN * Creatinine \<= 2.0mg/dl * Platelet count \>= 50,000/mm3 * HIV-1 therapy naive * 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) * Prior LAM, TDF, or ADV therapy * Active opportunistic infection * Other causes of chronic liver disease identified ( autoimmune hepatitis, haemochromatosis, 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