Prevention of Hepatitis Infection in HIV-Infected Patients

  • Edgar Turner Overton
  • Judith A. Aberg


For HIV-infected persons with access to potent antiretroviral therapy (ART), HIV infection can be controlled, and medically managed like other chronic medical conditions such as diabetes and hypertension [1, 2]. Despite the spectacular advances in therapy, there remain significant challenges for HIV care providers. Coinfection with viral hepatitis is one of these challenges, as liver-related diseases now are the leading significant cause of non-AIDS related deaths among HIV-infected patients [3, 4].


HBsAb Titer 
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  1. 1.
    Palella Jr FJ, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998;338:853–60.PubMedCrossRefGoogle Scholar
  2. 2.
    Vellozzi C, Brooks JT, Bush TJ, et al. The study to understand the natural history of HIV and AIDS in the Era of effective therapy (SUN study). Am J Epidemiol. 2009;169:642–52.PubMedCrossRefGoogle Scholar
  3. 3.
    Weber R, Sabin CA, Friis-Møller N, et al. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med. 2006;166:1632–41.PubMedCrossRefGoogle Scholar
  4. 4.
    Antiretroviral Therapy Cohort Collaboration. Causes of death in HIV-1-infected patients treated with antiretroviral therapy, 1996–2006: collaborative analysis of 13 HIV cohort studies. Clin Infect Dis. 2010;50:1387–96.CrossRefGoogle Scholar
  5. 5.
    Winnock M, Neau D, Castera L, et al. Hepatitis B vaccination in HIV-infected patients: a survey of physicians and patients participating in the Aquitaine cohort. Gastroenterol Clin Biol. 2006;30:189–95.PubMedCrossRefGoogle Scholar
  6. 6.
    Shehab TM, Sonnad SS, Lok AS. Management of hepatitis C patients by primary care physicians in the USA: results of a national survey. J Viral Hepat. 2001;8:377–83.PubMedCrossRefGoogle Scholar
  7. 7.
    Daniels D, Grytdal S. Centers for disease control and prevention (CDC). Surveillance for acute viral hepatitis – United States, 2007. MMWR Surveill Summ. 2009;58:1–27.PubMedGoogle Scholar
  8. 8.
    Diamond C, Thiede H, Perdue T, et al. Viral hepatitis among young men who have sex with men: prevalence of infection, risk behaviors, and vaccination. Sex Transm Dis. 2003;30:425–32.PubMedCrossRefGoogle Scholar
  9. 9.
    New York State Department of Health Institute. HIV Clinical Resource. Accessed 27 May 2010.
  10. 10.
    Lutwick LI. Clinical interactions between human immunodeficiency virus and the human hepatitis viruses. Infect Dis Clin Prac. 1999;8:9–20.CrossRefGoogle Scholar
  11. 11.
    Ida S, Tachikawa N, Nakajima A, et al. Influence of human immunodeficiency virus type 1 infection on acute hepatitis A virus infection. Clin Infect Dis. 2002;34:379–85.PubMedCrossRefGoogle Scholar
  12. 12.
    Alter M. Epidemiology of viral hepatitis and HIV co-infection. J Hepatol. 2006;44:6–9.CrossRefGoogle Scholar
  13. 13.
    Soriano V, Puoti M, Peters M, et al. Care of HIV patients with chronic hepatitis B: updated recommendations from the HIV-Hepatitis B Virus International Panel. AIDS. 2008;22:1399–410.PubMedCrossRefGoogle Scholar
  14. 14.
    Lee WM, Hepatitis B. Virus infection. N Engl J Med. 1997;337:1733–45.PubMedCrossRefGoogle Scholar
  15. 15.
    Weinbaum CM, Williams I, Mast EE, et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR Recomm Rep. 2008;57:1–20.PubMedGoogle Scholar
  16. 16.
    Vong S, Bell BP. Chronic liver disease mortality in the United States, 1990–1998. Hepatology. 2004;39:476–83.PubMedCrossRefGoogle Scholar
  17. 17.
    Kellerman SE, Hanson DL, McNaghten AD, Fleming PL. Prevalence of chronic hepatitis B and incidence of acute hepatitis B infection in human immunodeficiency virus-infected subjects. J Infect Dis. 2003;188:571–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Tien PC, Kovacs A, Bacchetti P, et al. Association between syphilis, antibodies to herpes simplex virus type 2, and recreational drug use and hepatitis B virus infection in the Women’s Interagency HIV Study. Clin Infect Dis. 2004;39:1363–70.PubMedCrossRefGoogle Scholar
  19. 19.
    Bodsworth N, Cooper D, Donovan B. The influence of human immunodeficiency virus type 1 infection on the development of the hepatitis B virus carrier state. J Infect Dis. 1991;163:1138–40.PubMedCrossRefGoogle Scholar
  20. 20.
    Gilson RJ, Hawkins AE, Beecham MR, et al. Interactions between HIV and hepatitis B in homosexual men: effects on the natural history of infection. AIDS. 1997;11:597–606.PubMedCrossRefGoogle Scholar
  21. 21.
    Thio CL, Seaberg EC, Skolasdy Jr R, et al. HIV-1, hepatitis B, and risk of liver-related mortality in the Multicenter AIDS Cohort Study (MACS). Lancet. 2002;360:1921–6.PubMedCrossRefGoogle Scholar
  22. 22.
    Eskild A, Magnus P, Petersen G, et al. Hepatitis B antibodies in HIV-infected homosexual men are associated with more rapid progression to AIDS. AIDS. 1992;6:571–4.PubMedCrossRefGoogle Scholar
  23. 23.
    Solomon RE, Van Raden M, Kaslow RA, et al. Association of hepatitis B surface antigen and core antibody with acquisition and manifestations of HIV-1 infection. Am J Public Health. 1990;80:1475–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Alter MJ. Epidemiology of hepatitis C. Hepatology. 1997;26:62S–5.PubMedCrossRefGoogle Scholar
  25. 25.
    Wasley A, Grytdal S. Centers for disease control and prevention (CDC). Surveillance for acute viral hepatitis – United States, 2006. MMWR Surveill Summ. 2008;57:1–24.PubMedGoogle Scholar
  26. 26.
    Kim WR. The burden of hepatitis C in the United States. Hepatology. 2002;36:S30–4.PubMedCrossRefGoogle Scholar
  27. 27.
    Alter MJ. Epidemiology of hepatitis C virus infection. World J Gastroenterol. 2007;13:2436–41.PubMedGoogle Scholar
  28. 28.
    Khalsa JH, Elkashef A. Interventions for HIV and hepatitis C virus infections in recreational drug users. Clin Infect Dis. 2010;50:1505–11.PubMedCrossRefGoogle Scholar
  29. 29.
    Gotz HM, van Doornum G, Niesters HG, et al. A cluster of acute hepatitis C virus infection among men who have sex with men – results from contact tracing and public health implications. AIDS. 2005;19:969–74.PubMedCrossRefGoogle Scholar
  30. 30.
    Richardson D, Fisher M, Sabin CA. Sexual transmission of hepatitis C in MSM may not be confined to those with HIV infection. J Infect Dis. 2008;197:1213–4.PubMedCrossRefGoogle Scholar
  31. 31.
    Wang CC, Krantz E, Klarquist J, et al. Acute hepatitis C in a contemporary US cohort: modes of acquisition and factors influencing viral clearance. J Infect Dis. 2007;196:1474–82.PubMedCrossRefGoogle Scholar
  32. 32.
    Mast EE, Hwang LY, Seto DS, et al. Risk factors for perinatal transmission of hepatitis C virus (HCV) and the natural history of HCV infection acquired in infancy. J Infect Dis. 2005;192:1880–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Aberg JA, Kaplan JE, Libman H, et al. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2009;49:651–81.PubMedCrossRefGoogle Scholar
  34. 34.
    European AIDS Clinical Society. Guidelines: Clinical Management and Treatment of HIV Infected Adults in Europe. Accessed 27 May 2010.
  35. 35.
    Chamie G, Bonacini M, Bangsberg DR, et al. Factors associated with seronegative chronic hepatitis C virus infection in HIV-infection. Clin Infect Dis. 2007;44:577–83.PubMedCrossRefGoogle Scholar
  36. 36.
    Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration, National Institutes of Health, HIV Medicine Association of the Infectious Diseases Society of America. Incorporating HIV prevention into the medical care of persons living with HIV. Recommendations of CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep. 2003;52:1–24.Google Scholar
  37. 37.
    U.S. Department of Health and Human Services. The HIV/AIDS Program: HAB Performance Measures. Accessed 10 Apr 2010.
  38. 38.
    Vlahov D, Robertson AM, Strathdee SA. Prevention of HIV infection among injection drug users in resource-limited settings. Clin Infect Dis. 2010;50:S114–21.PubMedCrossRefGoogle Scholar
  39. 39.
    Galvan FH, Bing EG, Fleishman JA, et al. The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. J Stud Alcohol. 2002;63:179–86.PubMedGoogle Scholar
  40. 40.
    McNeely J, Silvera R, Torres K, Bernstein K, et al. Current Substance Misuse and HIV Risk Behavior Among Highly Sexually Active Men Who Have Sex with Men (MSM) Attending Commercial Sex Venues, Events and Parties (CSVEP) in New York City. Society of General Internal Medicine (SGIM) 33rd Annual Meeting, April 28-May 1, 2010, Minneapolis MN. Abstract #198149.Google Scholar
  41. 41.
    Valle M, Levy J. Weighing the consequences: self-disclosure of HIV-positive status among African American injection drug users. Health Educ Behav. 2009;36:155–66.PubMedCrossRefGoogle Scholar
  42. 42.
    Gorbach PM, Galea JT, Amani B, et al. Don’t ask, don’t tell: patterns of HIV disclosure among HIV positive men who have sex with men with recent STI practising high risk behavior in Los Angeles and Seattle. Sex Transm Infect. 2004;80:512–7.PubMedCrossRefGoogle Scholar
  43. 43.
    Pisu M, Cloud G, Austin S, et al. Substance abuse treatment in an urban HIV clinic: who enrolls and what are the benefits? AIDS Care. 2010;22:348–54.PubMedCrossRefGoogle Scholar
  44. 44.
    Des Jarlais DC, Semaan S. HIV prevention for injecting drug users: the first 25 years and counting. Psychosom Med. 2008;70:606–11.PubMedCrossRefGoogle Scholar
  45. 45.
    Krantz MJ, Mehler PS. Treating opioid dependence. Growing implications for primary care. Arch Intern Med. 2004;164:277–88.PubMedCrossRefGoogle Scholar
  46. 46.
    Sees KL, Delucchi KL, Masson C, et al. Methadone maintenance vs. 180-day psychosocially enriched detoxification for treatment of opioid dependence: a randomized controlled trial. JAMA. 2000;283:1303–10.PubMedCrossRefGoogle Scholar
  47. 47.
    Novick DM, Joseph H, Croxson TS, et al. Absence of antibody to human immunodeficiency virus in long-term, socially rehabilitated methadone maintenance patients. Arch Intern Med. 1990;150:97–9.PubMedCrossRefGoogle Scholar
  48. 48.
    Gowing LR, Farrell M, Bornemann R, Sullivan LE, Ali RL. Methadone treatment of injecting opioid users for prevention of HIV infection. J Gen Intern Med. 2006;21:193–5.PubMedGoogle Scholar
  49. 49.
    Bell J, Zador D. A risk-benefit analysis of methadone maintenance treatment. Drug Saf. 2000;22:179–90.PubMedCrossRefGoogle Scholar
  50. 50.
    Clausen T, Anchersen K, Waal H. Mortality prior to, during and after opioid maintenance treatment (OMT): a national prospective cross-registry study. Drug Alcohol Depend. 2008;94:151–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Krantz MJ, Martin J, Stimmel B, Mehta D, Haigney MC. QTc interval screening in methadone treatment. Ann Intern Med. 2009;150:387–95.PubMedGoogle Scholar
  52. 52.
    Johnson RE, Chutuape MA, Strain EC, et al. A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence. N Engl J Med. 2000;343:1290–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Fischer G, Gombas W, Eder H, et al. Buprenorphine versus methadone maintenance for the treatment of opioid dependence. Addiction. 1999;94:1337–47.PubMedCrossRefGoogle Scholar
  54. 54.
    Heimer R, Khoshnood K, Jariwala-Freeman B, Duncan B, Harima Y. Hepatitis in used syringes: the limits of sensitivity of techniques to detect hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA, and antibodies to HBV core and HCV antigens. J Infect Dis. 1996;173:997–1000.PubMedCrossRefGoogle Scholar
  55. 55.
    Abdala N, Stephens PC, Griffith BP, Heimer R. Survival of HIV-1 in syringes. J Acquir Immune Defic Syndr Hum Retrovirol. 1999;20:73–80.PubMedCrossRefGoogle Scholar
  56. 56.
    Gleghorn AA, Doherty MC, Vlahov D, Celentano DD, Jones TS. Inadequate bleach contact times during syringe cleaning among injection drug users. J Acquir Immune Defic Syndr. 1994;7:767–72.PubMedGoogle Scholar
  57. 57.
    Institute of Medicine. Preventing HIV infection among injecting drug users in high risk countries: an assessment of the evidence. Accessed 27 May 2010.
  58. 58.
    World Health Organization. Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users. Accessed 27 May 2010.
  59. 59.
    Holtgrave DR, Pinkerton SD, Jones TS, Lurie P, Vlahov D. Cost and cost-effectiveness of increasing access to sterile syringes and needles as an HIV prevention intervention in the United States. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18:S133–8.PubMedGoogle Scholar
  60. 60.
    International Harm Reduction Association and Human Rights Watch. Building consensus: a reference guide to human rights and drug policy. Accessed 27 May 2010.
  61. 61.
    Ramos R, Ferreira-Pinto JB, Brouwer KC, et al. A tale of two cities: social and environmental influences shaping risk factors and protective behaviors in two Mexico-US border cities. Health Place. 2009;15:999–1005.PubMedCrossRefGoogle Scholar
  62. 62.
    Kaplan JE, Benson C, Holmes KH, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep. 2009;58:1–207.Google Scholar
  63. 63.
    Overton ET, Aberg JA. Hepatitis A and B immunization in persons infected with HIV. The Year in Hepat Vaccin. 2008;2:31–7.Google Scholar
  64. 64.
    Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2010. Ann Intern Med. 2010;152:36–9.Google Scholar
  65. 65.
    Overton ET, Nurutdinova D, Sungkanuparph S, et al. Predictors of immunity after hepatitis A vaccination in HIV-infected persons. J Viral Hepat. 2007;14:189–93.PubMedCrossRefGoogle Scholar
  66. 66.
    Tedaldi EM, Baker RK, Moorman AC, et al. Hepatitis A and B vaccination practices for ambulatory patients infected with HIV. Clin Infect Dis. 2004;38:1478–84.PubMedCrossRefGoogle Scholar
  67. 67.
    Rimland D, Guest JL. Response to hepatitis A vaccine in HIV patients in the HAART era. AIDS. 2005;19:1702–4.PubMedCrossRefGoogle Scholar
  68. 68.
    Weinberg A, Gona P, Nachman SA, et al. Antibody responses to hepatitis A virus vaccine in HIV-infected children with evidence of immunologic reconstitution while receiving highly active antiretroviral therapy. J Infect Dis. 2006;193:302–11.PubMedCrossRefGoogle Scholar
  69. 69.
    Ungulkraiwit P, Jongjirawisan Y, Atamasirikul K, Sungkanuparph S. Factors for predicting successful immune response to hepatitis B vaccination in HIV-1 infected patients. Southeast Asian J Trop Med Public Health. 2007;38:680–5.PubMedGoogle Scholar
  70. 70.
    Veiga AP, Casseb J, Duarte AJ. Humoral response to hepatitis B vaccination and its relationship with T CD45RA  +  (naïve) and CD45RO  +  (memory) subsets in HIV-1-infected subjects. Vaccine. 2006;24:7124–8.PubMedCrossRefGoogle Scholar
  71. 71.
    Cornejo-Juarez P, Volkow-Fernandez P, Escobedo-Lopez K. Randomized controlled trial of hepatitis B virus vaccine in HIV-1-infected patients comparing two different doses. AIDS Res Ther. 2006;6:3–9.Google Scholar
  72. 72.
    Shafran SD, Mashinter LD, Lindemulder A, et al. Poor efficacy of intradermal administration of recombinant hepatitis B virus immunization in HIV-infected individuals who fail to respond to intramuscular administration of hepatitis B virus vaccine. HIV Med. 2007;8:295–9.PubMedCrossRefGoogle Scholar
  73. 73.
    Fonseca MO, Pang LW, de Paula Cavalheiro N, Barone AA, Heloisa Lopes M. Randomized trial of recombinant hepatitis B vaccine in HIV-infected adult patients comparing a standard dose to a double dose. Vaccine. 2005;23:2902–8.PubMedCrossRefGoogle Scholar
  74. 74.
    Sasaki M, Foccacia R, deMessias-Reason IJ. Efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) as a vaccine adjuvant for hepatitis B virus in patients with HIV infection. Vaccine. 2003;21:4545–9.PubMedCrossRefGoogle Scholar
  75. 75.
    Overton ET, Kang M, Peters MG, et al. Immune Response to Hepatitis B Vaccine in HIV-Infected Subjects Using Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) as a Vaccine Adjuvant: ACTG Study 5220. Vaccine. Accepted for publication June 8, 2010.Google Scholar
  76. 76.
    Baylor NW, Egan W, Richman P. Aluminum salts in vaccines – US perspective. Vaccine. 2002;20:S18–23.PubMedCrossRefGoogle Scholar
  77. 77.
    Cooper CL, Angel JB, Seguin I, Davis HL, Cameron DW. CPG 7909 adjuvant plus hepatitis B virus vaccination in HIV-infected adults achieves long-term seroprotection for up to 5 years. Clin Infect Dis. 2008;46(8):1310–4.PubMedCrossRefGoogle Scholar
  78. 78.
    Fabrizi F, Ganeshan SV, Dixit V, Martin P. Meta-analysis: the adjuvant role of granulocyte macrophage-colony stimulating factor on immunological response to hepatitis B virus vaccine in end-stage renal disease. Aliment Pharmacol Ther. 2006;24:789–96.PubMedCrossRefGoogle Scholar
  79. 79.
    Cruciani M, Mengoli C, Serpelloni G, et al. Granulocyte macrophage colony-stimulating factor as an adjuvant for hepatitis B vaccination: a meta-analysis. Vaccine. 2007;25:709–18.PubMedCrossRefGoogle Scholar
  80. 80.
    Re 3rd VL, Frank I, Gross R, et al. Prevalence, risk factors, and outcomes for occult hepatitis B virus infection among HIV-infected patients. J Acquir Immune Defic Syndr. 2007;44:315–20.PubMedCrossRefGoogle Scholar
  81. 81.
    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;191:1435–41.PubMedCrossRefGoogle Scholar
  82. 82.
    Jongjirawisan Y, Ungulkraiwit P, Sungkanuparph S. Isolated antibody to hepatitis B core antigen in HIV-1 infected patients and a pilot study of vaccination to determine the anamnestic response. J Med Assoc Thai. 2006;89:2028–34.PubMedGoogle Scholar
  83. 83.
    Thomas-Gosain N, Adeyemi OM. Perceived significance of isolated HBcAb in patients with HIV: a survey of practitioners. AIDS Patient Care STDS. 2007;21:385–9.PubMedCrossRefGoogle Scholar
  84. 84.
    Ho YL, Enohata T, Lopes MH, De Sousa Dos Santos S. Vaccination in Brazilian HIV-infected adults: a cross-sectional study. AIDS Patient Care STDS. 2008;22:65–70.PubMedCrossRefGoogle Scholar
  85. 85.
    Mast EE, Margolis HS, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep. 2005;54:1–31.PubMedGoogle Scholar
  86. 86.
    Mast EE, Weinbaum CM, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm Rep. 2006;55:1–33.PubMedGoogle Scholar
  87. 87.
    Lum PJ, Hahn JA, Shafer KP, et al. Hepatitis B virus infection and immunization status in a new generation of injection drug users in San Francisco. J Viral Hepat. 2008;15:229–36.PubMedCrossRefGoogle Scholar
  88. 88.
    Judd A, Hickman M, Hope VD, et al. Twenty years of selective hepatitis B vaccination: is hepatitis B declining among injecting drug users in England and Wales? J Viral Hepat. 2007;14:584–91.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Internal Medicine/Infectious Diseases DivisionWashington University School of MedicineSt. LouisUSA
  2. 2.Department of Medicine, Bellevue Hospital CenterNew York University School of MedicineNew YorkUSA

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