Hepatitis B and human immunodeficiency virus co-infection

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share transmission routes, leading to high rates of chronic HBV in HIV-positive individuals.
• HIV infection significantly impacts the natural history of HBV, resulting in impaired viral clearance, accelerated liver fibrosis progression, and increased liver-related mortality compared to HBV monoinfection.

Purpose of the Study:

• To review the clinical implications of HIV-HBV co-infection.
• To highlight management strategies including screening, vaccination, and antiviral therapy.

Main Methods:

• Literature review focusing on the interplay between HBV and HIV.
• Analysis of current guidelines and research on diagnosis and treatment of co-infection.

Main Results:

• HIV-HBV co-infected patients face a worse prognosis for HBV disease, including higher risks of cirrhosis and hepatocellular carcinoma.
• Noninvasive fibrosis assessment tools and isolated hepatitis B core antibody (anti-HBc) testing for occult HBV infection are valuable.
• Vaccination is recommended for non-immune HIV patients, and optimal treatment involves tenofovir combined with lamivudine or emtricitabine, without interruption to prevent HBV reactivation.

Conclusions:

• Effective management of HIV-HBV co-infection requires comprehensive screening, timely vaccination, and continuous antiviral therapy.
• Long-term tenofovir therapy can reduce hepatitis B surface antigen levels, but HBV resistance and vaccine efficacy remain concerns.