Hepatitis delta and HIV infection

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis delta virus (HDV) is the most severe form of chronic viral hepatitis.
• HDV shares transmission routes with human immunodeficiency virus (HIV) and hepatitis B virus (HBV), leading to frequent co-infections, especially in intravenous drug users.
• HDV co-infection significantly accelerates liver disease progression, increasing risks of cirrhosis, decompensation, and mortality.

Purpose of the Study:

• To highlight the severity of HDV co-infection in HIV/HBV positive individuals.
• To emphasize the need for mandatory HDV screening in HBsAg-positive/HIV-positive patients.
• To review current therapeutic strategies and their limitations for HDV infection.

Main Methods:

• Literature review of HDV, HIV, and HBV co-infection.
• Analysis of clinical outcomes associated with triple viral infections.
• Evaluation of existing treatment modalities for HDV.

Main Results:

• Triple infection with HDV, HIV, and HBV leads to aggressive liver disease.
• Current treatments, including interferon, are effective in less than 30% of patients.
• HBV polymerase inhibitors may reduce viral loads in some co-infected individuals.

Conclusions:

• Mandatory screening for HDV antibodies is recommended for all HBsAg-positive/HIV-positive patients.
• Effective specific treatments for HDV are lacking.
• Early initiation of antiretroviral therapy (ART) for HIV may be beneficial, though further studies are needed.