HIV/AIDS/HBV

liver411

Kenneth H. Mayer, Section Editor


Treatment of Chronic Hepatitis B in the Human Immunodeficiency VirusInfected
Patient: Present and Future

Marina Núñez,1 Massimo Puoti,2 Nuria Camino,1 and Vincent Soriano1

Service of Infectious Diseases, Hospital Carlos III, Madrid, Spain; and
2Clinica di Malattie Infettive, Ospedali Civili, Brescia, Italy



The management of chronic hepatitis B poses specific problems in the
presence of human immunodeficiency virus (HIV) coinfection, because
therapeutic approaches have to address both hepatitis B virus (HBV) and HIV
infections. Response to interferon (IFN-) is lower in HBV-HIVcoinfected than
in HIV-negative subjects, especially in patients in advanced stages of
immunosuppression. Thus far, there are no data on the performance of the new
pegylated forms of IFN- in HBV- and HIV-coinfected persons. After prolonged
use of lamivudine, resistance develops in the majority of HBV-HIVcoinfected
patients treated with the drug. The more recently approved tenofovir has
shown excellent short-term results, and data from longer follow-up studies
are eagerly awaited. Several drugs with combined anti-HIV and anti-HBV
activity have recently been approved (emtricitabine) or are currently under
development. Preliminary results with some of them are quite promising and
probably will widen the therapeutic armamentarium against hepatitis B in
patients with HIV infection.