Joe Sasadeusz Victorian Infectious Diseases Service, Royal Melbourne Hospital and Infectious Diseases Unit, The Alfred Hospital, Melbourne VIC Last reviewed: November 2019 Introduction Hepatitis B virus (HBV) infection is an important infection in people with human immunodeficiency virus (HIV) infection because of the influence of HIV on the natural history of HBV infection. Antiviral therapies …
It is estimated that 257 million people worldwide, or approximately 5% of the global population, have chronic HBV infection. Areas of high endemicity for HBV infection, such as sub-Saharan Africa and Asia, are also most affected by the HIV pandemic.1 HIV and HBV infections occur commonly together because of their shared routes of transmission. The prevalence …
Serology All people with HIV infection should be screened for HBV infection. Hepatitis B surface antigen (HBsAg) is the classic marker indicative of chronic infection. Although the detection of HBsAg is usually sufficiently sensitive to establish the presence of chronic HBV infection in the normal host, individuals may occasionally be negative for HBsAg, but still …
Effect of HIV on HBV disease progression HIV co-infection results in considerable modification of the natural history of HBV infection.7-9 Persistent HBV infection is more common in people with HIV infection, with the prevalence of chronic HBV infection estimated at 25%10 compared with a prevalence of 3-5% in HIV-seronegative men who have sex with men. 11,12 Furthermore, during chronic …
General principles Sustained suppression of serum HBV DNA to below the level of detection by the most sensitive available assay method should be the goal of therapy and, at present, treatment of HBV in HIV- HBV co-infection is life-long. Current Australian and US guidelines recommend the consideration of cART in all people with HIV infection …
There are six currently licensed treatments available for the management of HBV infection. These include interferons, nucleoside reverse transcriptase inhibitors (lamivudine, emtricitabine, entecavir and telbivudine) and nucleotide reverse transcriptase inhibitors (tenofovir, tenofovir alafenamide and adefovir). Interferons In immunocompetent people, interferon-alfa (alfa-IFN) therapy may result in HBeAg seroconversion and induce a clinical remission in 20-40% of …
HBV infection in people with HIV infection may result in significant morbidity and mortality. People with HIV-HBV co-infection have higher rates of chronic HBV infection and accelerated hepatic fibrosis and cirrhosis compared with those with HBV infection who do not have HIV infection. Management of each viral infection is complicated by the presence of the …
Lok AS, McMahon BJ. American Association for the Study of Liver Diseases Practice Guidelines. Chronic Hepatitis B. Hepatology 2007;45:507-39. Chronic Hepatitis B: Update 2009 http://www.aasld.org/sites/default/files/guideline_documents/ChronicHepatitisB2009.pdf Cooley L, Ayres A, Bartholomeusz A, et al. Prevalence and characterization of lamivudine-resistant hepatitis B virus mutations in HIV-HBV co-infected individuals. AIDS 2003;17:1649-57. Perrillo R. Acute flares in chronic hepatitis …
Developing a sustainable HIV, Viral Hepatitis and Sexual Health Workforce
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