Hepatitis B virus coinfection in human immunodeficiency virus-infected patients: a review

World J Gastroenterol. 2014 Oct 28;20(40):14598-614. doi: 10.3748/wjg.v20.i40.14598.

Abstract

Hepatitis B virus (HBV) infection is a leading cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma worldwide. Due to the shared modes of transmission, coinfection with HBV and human immunodeficiency virus (HIV) is not uncommon. It is estimated that 10% of HIV-infected patients worldwide are coinfected with HBV. In areas where an HBV vaccination program is implemented, the HBV seroprevalence has declined significantly. In HIV/HBV-coinfected patients, HBV coinfection accelerates immunologic and clinical progression of HIV infection and increases the risk of hepatotoxicity when combination antiretroviral therapy (cART) is initiated, while HIV infection increases the risk of hepatitis events, cirrhosis, and end-stage liver disease related to chronic HBV infection. With the advances in antiviral therapy, concurrent, successful long-term suppression of HIV and HBV replication can be achieved in the cART era. To reduce the disease burden of HBV infection among HIV-infected patients, adoption of safe sex practices, avoidance of sharing needles and diluent, HBV vaccination and use of cART containing tenofovir disoproxil fumarate plus emtricitabine or lamivudine are the most effective approaches. However, due to HIV-related immunosuppression, using increased doses of HBV vaccine and novel approaches to HBV vaccination are needed to improve the immunogenicity of HBV vaccine among HIV-infected patients.

Keywords: Nucleoside reverse-transcriptase inhibitor; Seroepidemiology; Sexually transmitted diseases; Vaccination; Viral hepatitis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-HIV Agents / therapeutic use
  • Coinfection*
  • Disease Progression
  • Drug Resistance, Viral
  • HIV / pathogenicity
  • HIV Infections* / diagnosis
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / immunology
  • HIV Infections* / transmission
  • Hepatitis B Vaccines / therapeutic use
  • Hepatitis B virus / pathogenicity
  • Hepatitis B, Chronic* / diagnosis
  • Hepatitis B, Chronic* / drug therapy
  • Hepatitis B, Chronic* / epidemiology
  • Hepatitis B, Chronic* / immunology
  • Hepatitis B, Chronic* / prevention & control
  • Hepatitis B, Chronic* / transmission
  • Host-Pathogen Interactions
  • Humans
  • Remission Induction
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • Hepatitis B Vaccines