The course and treatment of chronic hepatitis B in HIV-infected patients

Abstract

The paper reviews the data available in the literature on patients with mixed hepatitis B virus (HBV) and HIV infection, its course and outcomes. The unity of the mechanisms of contamination with HBV and HIV increases the likelihood of these infections in patients. About 70% of HIV-infected patients are carriers of the markers, the presence of which is indicative of current or previous HBV infection. An average of 7.6% of HIV-infected patients were diagnosed as having chronic hepatitis B (CHB) in West Europe and North America. The notification rate of CHB in adult HIV-infected patients was 5-7% in the Russian Federation. Most specialists report that HIV-infected patients have a severer course of HBV. Mixed HBV and HIV infection, and low CD4+ lymphocyte count in particular, increase the risk for death from hepatic diseases and there is evident hepatotoxicity during antiretroviral therapy. The management of patients with mixed HBV and HIV infection is determined by indications for therapy for both HIV infection and CHV infection, by the availability of double-action antiviral drugs (that suppress either HIV or HBV replication), by the development of their resistance in one or both viruses. Indications and preferable variants of using various treatment regimens are given.

Keywords

• hiv infection
• chronic hepatitis b
• antiretroviral therapy
• nucleoside (nucleotide) analogues