Clinical aspects of the interactions between human immunodeficiency virus and the hepatotropic viruses.
The hepatitis viruses A through D are prevalent among patients at risk for human immunodeficiency virus (HIV) infection. The courses of hepatitis B, C, and D are modified by HIV infection. With hepatitis B, increased carriage rates, increased viral replication, and milder liver injury are seen. The degree of HIV-induced immunosuppression does not correlate well with liver injury or amount of hepatitis B viral replication. With progression to AIDS, surface antibody titers can decline, resulting in reactivation of latent hepatitis B virus or reinfection with another subtype. hepatitis B virus may enhance progression to AIDS. Preliminary data suggest that HIV infection can prolong or increase hepatitis C or D viremia and decrease the accuracy of tests for hepatitis C. Interferon may have efficacy against hepatitis C but rarely against hepatitis B in patients who are coinfected with HIV. Zidovudine, ganciclovir, and foscarnet also may be active against these hepatotropic viruses.
Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2605.
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Raffanti
D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology; D000998:Antiviral Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D003699:Hepatitis D / Q000150:complications; D006521:Hepatitis, Chronic / Q000150:complications; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use
D000998:Antiviral Agents; D016898:Interferon-alpha