HIV/AIDS: Antiretroviral Therapy for Hepatitis B Virus–HIV–Coinfected Patients: Promises and Pitfalls

Levy, Vivian; Grant, Robert M.

doi:10.1086/507532

Cited by 64 publications

(53 citation statements)

References 30 publications

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“…Some researchers focus on treating one virus at a time, while others declare it safe to treat both simultaneously. If treatment is indicated in an HBV/HIV co-infected patient, some factors such as combination ART for HIV infection, the severity of liver disease, probability of various reactions and potential adverse events should be taken into account 42 . When treatment is necessary for both HBV and HIV infections, HAART is needed for HIV.…”

Section: Treating Hiv and Hbv Infections Concomitantlymentioning

confidence: 99%

HIV/HBV Co-infection - A Global Challenge

Tumpa

Mamun

2015

Bangladesh J Med Sci

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Abstract:With prevalence worldwide approximately 10% of the HIV-infected population is infected with hepatitis B. In persons with HBV and HIV co-infection, HBV-related liver disease progresses more rapidly than in those with HBV mono-infection leading to increased rates of persistent infection, higher HBV DNA levels, increased cirrhosis and liver-related mortality, increased risk of hepatocellular carcinoma, and decreased efficacy of anti-HBV therapy. Furthermore, HIVinfected patients co-infected with HBV have an increased risk for antiretroviral therapy-related hepatotoxicity. The management of hepatitis B in co-infected patients is complicated because HIV substantially impacts the outcome of HBV. For all of these reasons, effective treatment of HBV in persons co-infected with HIV is clearly high priority. If treatment is indicated in an HBV/HIV co-infected patient, the severity of liver disease, probability of various reactions and potential adverse events should be taken into account. Combination therapy should be used to avoid development of antiviral resistance. Continuous monitoring of HBV patients, the choice of antiviral therapy or history of seroconversion, is vital to recognize reactivation and subsequent need for treatment, to identify drug resistance and viral breakthrough early. Further work is also needed on how to optimize anti-HBV therapy in HIV/HBV co-infected persons and to determine which combinations are most effective and least toxic together with anti-HIV regimens. Little data, however, are available on HIV/HBV co-infection from regions with high chronic hepatitis B prevalence. The authors aim to bring to light the overall status of HIV/HBV co-infection.

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Section: Treating Hiv and Hbv Infections Concomitantlymentioning

confidence: 99%

HIV/HBV Co-infection - A Global Challenge

Tumpa

Mamun

2015

Bangladesh J Med Sci

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“…It is estimated that there are over 500 million cases of malarial infection annually, mostly in Africa, and dual infection of HIV and malaria facilitates the geographical expansion of each [64]. HCV and HBV infections are also highly prevalent among the HIV population [65,66].…”

Section: Hiv Diversity Enables Escape From Detectionmentioning

confidence: 99%

“…These coinfections are not only widespread and increase mortality rates, but they also reduce the accuracy of HIV tests [62,[65][66][67][68][69], creating a need for diagnostics that can quickly and reliably account for these coinfections. Using TB as an example, the analytical and clinical techniques used for diagnosis include sputum smear microscopy and culture, but these methods are inaccurate (microscopy misses 50% of cases) and not rapid (cultures may require days) [62,70].…”

Section: Presence Of Coinfectionsmentioning

confidence: 99%

HIV Diagnostics: Challenges and Opportunities

Wong

Hewlett

2010

HIV Ther.

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Accurate HIV diagnostic testing continues to pose challenges, but there are also opportunities for assay performance improvements in key areas for specific intended-use settings. The genetic diversity of HIV can result in false and discordant results in assays that fail to detect new variant strains. The use of antiretroviral therapies has resulted in drug-resistant variants that require monitoring by sequencing and genotyping methods. Nucleic acid testing is the most sensitive and reliable platform for detection, but it is costly and limited to centralized testing facilities, making implementation difficult in resource-limited settings where HIV has hit the hardest. Rapid antibody tests suitable for point-of-care use are becoming more accessible in resource-limited settings, but these tests may not detect HIV during the acute infection stage. Emerging antigen/antibody combination assays are viable alternatives to nucleic acid testing for diagnosis of recent infections. Although patient monitoring (e.g., via CD4+ T-cell count and viral load determination) and infant diagnoses still rely on clinical laboratory-based testing, point-of-care options are being developed. There are other technical challenges to HIV diagnostic testing and emerging biodetection technologies that may be able to address them, but they are not yet proven.

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“…An additional double-blind, placebo-controlled trial showed that tenofovir may be a useful component of antiretroviral therapy for HIV/HBV co-infected patients. Importantly, tenofovir is equivalent to adefovir in its ability to reduce HBV DNA levels, and may, in fact, be superior [17] . If HBV treatment can be deferred until combination antiretroviral therapy for HIV infection is needed, the combination of tenofovir plus lamivudine or emtricitabine will be the potent HBV therapy and a solid backbone for HIV combination antiretroviral therapy, and a potent treatment for HBV and it likely decreases the emergence of HBV resistance.…”

Section: Tenofovir (Viread Pmpa)mentioning

confidence: 99%

Novel approaches towards conquering hepatitis B virus infection

Wu¹

2007

WJG

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Currently approved treatments for hepatitis B virus (HBV) infection include the immunomodulatory agent, IFN-α, and nucleos(t)ide analogues. Their efficacy is limited by their side effects, as well as the induction of viral mutations that render them less potent. It is thus necessary to develop drugs that target additional viral antigens. Chemicals and biomaterials by unique methods of preventing HBV replication are currently being developed, including novel nucleosides and newly synthesized compounds such as capsid assembling and mRNA transcription inhibitors. Molecular therapies that target different stages of the HBV life cycle will aid current methods to manage chronic hepatitis B (CHB) infection. The use of immunomodulators and gene therapy are also under consideration. This report summarizes the most recent treatment possibilities for CHB infection. Emerging therapies and their potential mechanisms, efficacy, and pitfalls are discussed.

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HIV/AIDS: Antiretroviral Therapy for Hepatitis B Virus–HIV–Coinfected Patients: Promises and Pitfalls

Cited by 64 publications

References 30 publications

HIV/HBV Co-infection - A Global Challenge

HIV/HBV Co-infection - A Global Challenge

HIV Diagnostics: Challenges and Opportunities

Novel approaches towards conquering hepatitis B virus infection

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