Coinfection

AIDS 2010: Drug Resistance Linked to Faster Hepatitis B Liver Disease Progression in HIV/HBV Coinfected Patients

HIV/HBV coinfected individuals may be less likely to have hepatitis B virus (HBV) with mutations conferring resistance to lamivudine (3TC; Epivir), but those who do have drug resistance experience faster liver disease progression and are more likely to develop cirrhosis, according to a study from Romania presented last month at the XVIII International AIDS Conference (AIDS 2010) in Vienna.

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National Viral Hepatitis Roundtable Applauds National AIDS Strategy's Recognition of HIV/HCV Coinfection

The National Viral Hepatitis Roundtable (NVHR) praised the inclusion of hepatitis B and C coinfection in the White House Office of National AIDS Policy's National HIV/AIDS Strategy released last week, given that an about 30% of HIV positive people also have HCV and approximately 10% also have HBV. The advocates also expressed hope that the administration will take a similar comprehensive approach to hepatitis B and C monoinfection, the latter of which affects about 4 times as many people as HIV.

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HIV-HBV Coinfected Patients Respond to Antiretroviral Therapy as well as HIV Monoinfected, but Have a Higher Risk of Non-AIDS Death

HIV positive people coinfected with hepatitis B virus (HBV) respond as well to combination antiretroviral therapy (ART) as individuals with HIV alone, but they are more likely to die due to non-AIDS-related causes, according to a study published in the September 10, 2009 issue of AIDS.

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Elevated ALT Liver Enzymes in HIV Patients without Hepatitis B or C Are Linked to High Viral Load, Obesity, Alcohol, and Some NRTIs

Among HIV positive individuals without coexisting hepatitis C virus (HCV) or hepatitis B virus (HBV) infection, the incidence of persistent elevated ALT levels was 3.9 cases per 100 person-years, researchers reported in the February 15, 2010 issue of Clinical Infectious Diseases. The risk of ALT elevation was greater in people with high HIV RNA levels, higher body mass index (BMI), heavy alcohol use, and prolonged use of stavudine (d4T; Zerit) or zidovudine (AZT; Retrovir).

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Meta-analysis Shows Concurrent Hepatitis B Increases All-cause Mortality in People with HIV

HIV positive people coinfected with hepatitis B virus (HBV) have a higher rate of all-cause death than people with HIV alone, according to a report in the June 15, 2009 issue of Clinical Infectious Diseases. These results, the study authors stated, suggest that HIV-HBV coinfected individuals may especially benefit from efforts to minimize liver damage.

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ICAAC 2009: Resistance to Hepatitis B Drugs is Common among HIV-HBV Coinfected Patients Receiving Lamivudine-containing ART without Tenofovir (Viread)

Resistance to the hepatitis B drugs adefovir (Hepsera), entecavir (Baraclude), and telbivudine (Tyzeka) is common among HIV-HBV coinfected individuals treated with antiretroviral therapy (ART) regimens that include lamivudine (3TC; Epivir) without tenofovir (Viread, also in the Truvada and Atripla coformulations), according to a poster presented at 49th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2009) this week in San Francisco. These findings support the recommendation that coinfected patients should be treated with ART regimens containing at least 2 drugs with dual activity against HIV and HBV.

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CROI 2009: Antiretroviral Treatment Interruption May Affect HCV Viral Load, HBV Rebound, and Liver Fibrosis Progression in Coinfected Patients

Over the past few years, evidence has accumulated showing that antiretroviral treatment interruption is a potentially risky strategy, and that ongoing HIV replication is associated with a variety of non-AIDS conditions even in people with relatively well-preserved immune function.

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HIV/HBV Coinfected Patients Respond to ART as well as HIV Monoinfected

HIV positive people coinfected with hepatitis B virus (HBV) respond as well to combination antiretroviral therapy (ART) as individuals with HIV alone, but they are more likely to die due to non-AIDS-related causes, according to a study published in the September 10, 2009 issue of AIDS.

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Liver Enzyme Elevation after Lamivudine (Epivir) Withdrawal in HIV-HBV Coinfected Patients

Assessment of liver enzyme elevation in HIV positive patients coinfected with hepatitis B virus (HBV) can be complicated, since increases may be attributable to multiple causes including heavy alcohol use, liver toxicity related to antiretroviral therapy (ART), immune reconstitution due to effective anti-HIV therapy, and exacerbation of HBV infection -- especially when anti-HBV therapy is discontinued.

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