Abstract
Hepatitis B virus (HBV) is a common coinfection in HIV-infected patients, and significant liver disease and mortality occur as the result of this disease combination. Potent anti-HBV therapy is available and can be used to improve outcomes by suppressing HBV DNA. Many HBV agents have dual activity with HIV and may be used to treat both diseases. However, care must be taken when using HBV nucleos(t)ides that have not been fully studied in the HIV-infected population because the emergence of strains resistant to HIV treatment has been reported. Careful monitoring of response to treatment is needed when treating an HIV/HBV patient with severe immune suppression. Improved ability to obtain long-term HBV DNA suppression and avoid resistance will translate into improved survival in this population.
Similar content being viewed by others
References and Recommended Reading
Thio CL, Seaberg EC, Skolasky R Jr, et al.: HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS). Lancet 2002, 360:1921–1926.
Di Martino V, Thevenot T, Colin JF, et al.: Influence of HIV infection on the response to interferon therapy and the long-term outcome of chronic hepatitis B. Gastroenterology 2002, 123:1812–1822.
Iloeje UH, Yang HI, Su J, et al.: Predicting cirrhosis risk based on the level of circulating hepatitis B viral load. Gastroenterology 2006, 130:678–686.
Bonacini M, Louie S, Bzowej N, Wohl AR: Survival in patients with HIV infection and viral hepatitis B or C: a cohort study. AIDS 2004, 18:2039–2045.
Osborn MK, Guest JL, Rimland D: Hepatitis B virus and HIV coinfection: relationship of different serological patterns to survival and liver disease. HIV Med 2007, 8:271–279.
Gandhi RT, Wurcel A, Lee H, et al.: Response to hepatitis B vaccine in HIV-1-positive subjects who test positive for isolated antibody to hepatitis B core antigen: implications for hepatitis B vaccine strategies. J Infect Dis 2005, 191:1435–1441.
Seremba E, Joshi R, Attar N, et al.: Liver disease progression among HIV-infected patients with viral hepatitis [abstract]. Presented at the 58th Annual Meeting of the American Association for the Study of Liver Diseases. Boston, MA; November 2–6, 2007.
Soriano V, Barreiro P, Martin-Carbonero L, et al.: Treatment of chronic hepatitis B or C in HIV-infected patients with dual viral hepatitis. J Infect Dis 2007, 195:1181–1183.
Chan HL, Hui AY, Wong ML, et al.: Genotype C hepatitis B virus infection is associated with an increased risk of hepatocellular carcinoma. Gut 2004, 53:1494–1498.
Flink HJ, van Zonneveld M, Hansen BE, et al.: Treatment with peg-interferon alpha-2b for HBeAg-positive chronic hepatitis B: HBsAg loss is associated with HBV genotype. Am J Gastroenterol 2006, 101:297–303.
Jain MK, Comanor L, White C, et al.: Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV-coinfected patients: factors associated with response. J Viral Hepat 2007, 14:176–182.
Chu CJ, Keeffe EB, Han SH, et al.: Hepatitis B virus genotypes in the United States: results of a nationwide study. Gastroenterology 2003, 125:444–451.
Lacombe K, Massari V, Girard PM, et al.: Major role of hepatitis B genotypes in liver fibrosis during coinfection with HIV. AIDS 2006, 20:419–427.
Mommeja-Marin H, Mondou E, Blum MR, Rousseau F: Serum HBV DNA as a marker of efficacy during therapy for chronic HBV infection: analysis and review of the literature. Hepatology 2003, 37:1309–1319.
Schmutz G, Nelson M, Lutz T, et al.: Combination of tenofovir and lamivudine versus tenofovir after lamivudine failure for therapy of hepatitis B in HIV-coinfection. AIDS 2006, 20:1951–1954.
McMahon MA, Jilek BL, Brennan TP, et al.: The HBV drug entecavir—effects on HIV-1 replication and resistance. N Engl J Med 2007, 356:2614–2621.
Jain MK, Zoellner CL: Entecavir can select for M184V of HIV-1: a case of an HIV/hepatitis B (HBV) naive patient treated for chronic HBV. AIDS 2007, 21:2365–2366.
Wei X, Liang C, Gotte M, Wainberg MA: The M184V mutation in HIV-1 reverse transcriptase reduces the restoration of wild-type replication by attenuated viruses. AIDS 2002, 16:2391–2398.
Mohamadnejad M, Montazeri G, Fazlollahi A, et al.: Noninvasive markers of liver fibrosis and inflammation in chronic hepatitis B-virus related liver disease. Am J Gastroenterol 2006, 101:2537–2545.
Brook MG, Chan G, Yap I, et al.: Randomised controlled trial of lymphoblastoid interferon alfa in Europid men with chronic hepatitis B virus infection. BMJ 1989, 299:652–656.
Benhamou Y, Katlama C, Lunel F, et al.: Effects of lamivudine on replication of hepatitis B virus in HIV-infected men. Ann Intern Med 1996, 125:705–712.
Dore GJ, Cooper DA, Barrett C, et al.: Dual efficacy of lamivudine treatment in human immunodeficiency virus/hepatitis B virus-coinfected persons in a randomized, controlled study (CAESAR). The CAESAR Coordinating Committee. J Infect Dis 1999, 180:607–613.
Matthews GV, Bartholomeusz A, Locarnini S, et al.: Characteristics of drug resistant HBV in an international collaborative study of HIV-HBV-infected individuals on extended lamivudine therapy. AIDS 2006, 20:863–870.
Bessesen M, Ives D, Condreay L, et al.: Chronic active hepatitis B exacerbations in human immunodeficiency virus-infected patients following development of resistance to or withdrawal of lamivudine. Clin Infect Dis 1999, 28:1032–1035.
Pillay D, Cane PA, Ratcliffe D, et al.: Evolution of lamivudine-resistant hepatitis B virus and HIV-1 in co-infected individuals: an analysis of the CAESAR study. CAESAR co-ordinating committee. AIDS 2000, 14:1111–1116.
Raffi F, Snow A, Borroto-Esoda K, et al.: Anti-HBV activity of emtricitabine (FTC) in patients co-infected with HIV and hepatitis B virus [oral presentation]. Presented at the 2nd International AIDS Conference on Pathogenesis and Treatment. Paris, France; July 13–16, 2003.
Benhamou Y, Thibault V, Vig P, et al.: Safety and efficacy of adefovir dipivoxil in patients infected with lamivudine-resistant hepatitis B and HIV-1. J Hepatol 2006, 44:62–67.
Karatayli E, Karayalcin S, Karaaslan H, et al.: A novel mutation pattern emerging during lamivudine treatment shows cross-resistance to adefovir dipivoxil treatment. Antivir Ther 2007, 12:761–768.
Tan J, Degertekin B, Wong SN, et al.: Tenofovir monotherapy is effective in hepatitis B patients with antiviral treatment failure to adefovir in the absence of adefovir-resistant mutations. J Hepatol 2008, 48:391–398.
Benhamou Y, Tubiana R, Thibault V: Tenofovir disoproxil fumarate in patients with HIV and lamivudine-resistant hepatitis B virus. N Engl J Med 2003, 348:177–178.
van Bommel F, Wunsche T, Schurmann D, Berg T: Tenofovir treatment in patients with lamivudine-resistant hepatitis B mutants strongly affects viral replication. Hepatology 2002, 36:507–508.
van Bommel F, Zollner B, Sarrazin C, et al.: Tenofovir for patients with lamivudine-resistant hepatitis B virus (HBV) infection and high HBV DNA level during adefovir therapy. Hepatology 2006, 44:318–325.
Peters MG, Andersen J, Lynch P, et al.: Randomized controlled study of tenofovir and adefovir in chronic hepatitis B virus and HIV infection: ACTG A5127. Hepatology 2006, 44:1110–1116.
Sheldon J, Camino N, Rodes B, et al.: Selection of hepatitis B virus polymerase mutations in HIV-coinfected patients treated with tenofovir. Antivir Ther 2005, 10:727–734.
Chang TT, Lai CL: Hepatitis B virus with primary resistance to adefovir. N Engl J Med 2006, 355:322–323; author reply 323.
Sherman M, Yurdaydin C, Sollano J, et al.: Entecavir for treatment of lamivudine-refractory, HBeAg-positive chronic hepatitis B. Gastroenterology 2006, 130:2039–2049.
Tenney DJ, Levine SM, Rose RE, et al.: Clinical emergence of entecavir-resistant hepatitis B virus requires additional substitutions in virus already resistant to lamivudine. Antimicrob Agents Chemother 2004, 48:3498–3507.
Chan HL, Heathcote EJ, Marcellin P, et al.: Treatment of hepatitis B e antigen positive chronic hepatitis with telbivudine or adefovir: a randomized trial. Ann Intern Med 2007, 147:745–754.
Lai CL, Leung N, Teo EK, et al.: A 1-year trial of telbivudine, lamivudine, and the combination in patients with hepatitis B e antigen-positive chronic hepatitis B. Gastroenterology 2005, 129:528–536.
Dore GJ, Cooper DA, Pozniak AL, et al.: Efficacy of tenofovir disoproxil fumarate in antiretroviral therapy-naive and-experienced patients coinfected with HIV-1 and hepatitis B virus. J Infect Dis 2004, 189:1185–1192.
Gaglio PJ, Sterling R, Daniels E, Tedaldi E: Hepatitis B virus and HIV coinfection: results of a survey on treatment practices and recommendations for therapy. Clin Infect Dis 2007, 45:618–623.
Jain MK, Opio CK, Osuagwu CC, et al.: Do HIV care providers appropriately manage hepatitis B in coinfected patients treated with antiretroviral therapy? Clin Infect Dis 2007, 44:996–1000.
McGovern BH, Golan Y, Lopez M, et al.: The impact of cirrhosis on CD4+ T cell counts in HIV-seronegative patients. Clin Infect Dis 2007, 44:431–437.
Roland ME, Barin B, Carlson L, et al.: HIV-infected liver and kidney transplant recipients: 1-and 3-year outcomes. Am J Transplant 2008, 8:355–365.
Lee WM: Hepatitis B virus infection. N Engl J Med 1997, 337:1733–1745.
Reisler RB, Han C, Burman WJ, et al.: Grade 4 events are as important as AIDS events in the era of HAART. J Acquir Immune Defic Syndr 2003, 34:379–386.
Rouanet I, Peyriere H, Mauboussin JM, et al.: Acute clinical hepatitis by immune restoration in a human immunodeficiency virus/hepatitis B virus co-infected patient receiving antiretroviral therapy. Eur J Gastroenterol Hepatol 2003, 15:95–97.
Nuesch R, Ananworanich J, Srasuebkul P, et al.: Interruptions of tenofovir/emtricitabine-based antiretroviral therapy in patients with HIV/hepatitis B virus co-infection. AIDS 2008, 22:152–154.
Drake A, Mijch A, Sasadeusz J: Immune reconstitution hepatitis in HIV and hepatitis B coinfection, despite lamivudine therapy as part of HAART. Clin Infect Dis 2004, 39:129–132.
Jain MK, Parekh NK, Hester J, Lee WM: Aminotransferase elevation in HIV/hepatitis B virus co-infected patients treated with two active hepatitis B virus drugs. AIDS Patient Care STDS 2006, 20:817–822.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kitchell, E., Jain, M.K. Evaluation and treatment of the patient coinfected with hepatitis B and HIV. Curr HIV/AIDS Rep 5, 103–111 (2008). https://doi.org/10.1007/s11904-008-0017-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11904-008-0017-1