[Diagnostic, clinical and therapeutic implications of viral hepatitides in HIV-infected patients].
Viral hepatitis B (HBV) and C (HCV) are a significant cause of morbidity and mortality in patients coinfected with human immunodeficiency virus (HIV). In HBV/HIV coinfection, there is a higher frequency of HBV replication, and higher rates of HBV-associated liver disease. The only drugs currently approved for the treatment of HBV infection are lamivudine, adefovir, entecavir, and interferon-a. HIV/HBV coinfection is associated with an increased frequency of hepatotoxicity in patients receiving highly active antiretroviral therapy (HAART), and reactivation of clinical hepatitis is observed upon stopping HBV-active anti-HIV drugs. Liver disease due to HCV infection is currently the leading cause of mortality among HIV-infected patients in the developed world. The treatment of choice of chronic hepatitis C in these patients is based on pegylated interferon in combination with ribavirin, which achieves sustained virological response rates of up to 40%. However, patients with HCV/HIV coinfection show accelerated progression to cirrhosis and are at increased risk of hepatotoxicity from HAART.
Toro Rueda
Carlos
C
Servicio de Enfermedades Infecciosas, Hospital Carlos III, Madrid, España.
Ramos Blázquez
Belén
B
Soriano Vázquez
Vicente
V
D000465:Algorithms; D000998:Antiviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D004347:Drug Interactions; D015658:HIV Infections / Q000150:complications*; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans
D000998:Antiviral Agents