title: Hepatitis B virus co-infection in human immunodeficiency virus-infected subjects.
abstract: Shared epidemiological risks have resulted in HIV-infected populations having a high prevalence of hepatitis B virus (HBV) co-infection. Several prospective studies have investigated the impact of HBV co-infection on HIV disease progression; most of them were negative. On the contrary, there is evidence that HIV may modify the natural history of HBV infection. HIV positive subjects have higher rates of HBV chronification, higher HBV replication, lower ALT levels and lower rates of seroconversion to anti-HBe and anti-HBs. The impact of HIV co-infection on the outcome of HBV infection is still controversial, even if some studies have shown an accelerated progression towards decompensated cirrhosis in HIV co-infected subjects. HBV co-infection is a risk factor for severe hepatotoxicity during HAART. Vaccination for HBV is mandatory in nonimmune HIV subjects, however its efficacy in immunosuppressed patients is still controversial. HIV co-infection decreases the effectiveness of Interferon in the treatment of HBV infection. Because of its activity against both HBV and HIV, lamivudine is used in HIV-HBV co-infected patients at doses of 300 mg/daily and as part of an antiretroviral regimen, but the rate of sustained response is poor and HBV strains with mutations associated with lamivudine resistance occur at a rate of 20% per year. Trials of new drugs with activity against HBV, some of them with activity also against HIV, and some of them without cross-resistance with lamivudine, are now underway. Highly Active Anti-Hepatitis B Therapy will probably soon come of age.
authors: Clinica di Malattie Infecttive e Tropicali, Università degli studi de Brescia, AO Spedali Civili dei Brescia. m.puoti@iol.it
authors: Massimo
authors: M
authors: Puoti
authors: Monica
authors: M
authors: Airoldi
authors: Raffaele
authors: R
authors: Bruno
authors: Barbara
authors: B
authors: Zanini
authors: Angiola
authors: A
authors: Spinetti
authors: Chiara
authors: C
authors: Pezzoli
authors: Andrea
authors: A
authors: Patroni
authors: Francesco
authors: F
authors: Castelli
authors: Paolo
authors: P
authors: Sacchi
authors: Gaetano
authors: G
authors: Filice
authors: Giampiero
authors: G
authors: Carosi
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male
chemical_list: D000998:Antiviral Agents