In addition to RAMs, there are other explanations for incomplete suppression of HBV viraemia on therapy25,33, including a higher baseline HBV DNA level, positive baseline HBeAg status, history of 3TC exposure, a lower nadir CD4+ T cell count in the context of HIV coinfection, and high serum HBV RNA levels44,50,51. This evidence concerns the gene CD4 and coinfection.