Incidence of liver cirrhosis in HIV-infected patients with chronic hepatitis B or C in the era of highly active antiretroviral therapy

Abstract

Development of liver cirrhosis in HIV-infected individuals in the HAART era is mainly associated with active HCV coinfection. The risk of developing cirrhosis is negligible in patients who cleared HCV with therapy, as well as in HIV-HBV-coinfected patients on long-term suppressive tenofovir disoproxil fumarate therapy.

HIV/HBV Coinfection

“…As antiretrovirals with a dual antiviral activity (active against both HIV and HBV which share a reverse transcription in their replication cycle) have been used more extensively, the natural history of liver disease has markedly changed this last decade with a reduced incidence of cirrhosis and stabilization or even improvement in the liver severity of the HBV-related disease. Indeed, morbidity and mortality decreased in treated patients in comparison with untreated patients [11,12], as shown by the diminution of decompensated cirrhosis under antiretroviral therapies including tenofovir [13]. As detailed further in the EPIB 2012 study, one could even suggest that HIV coinfection, unlike HCV or HDV coinfection, no longer seems to worsen HBV-induced fibrosis in highly active antiretroviral therapy (HAART)-treated patients.…”

Current treatment for chronic hepatitis C virus/HIV-infected individuals

“…At a Madrid Centre [15], the incidence of hepatic cirrhosis as assessed by elastography was negligible in patients achieving an SVR compared with untreated or nonresponder patients. In a multicentre Spanish study of over 700 HIV/HCV patients who received anti-HCV treatment, among the 31% of patients who achieved an SVR there was a significant reduction in overall mortality and specifically liver-related mortality and episodes of hepatic decompensation during a mean of 20-month follow-up period [16].…”

Recent advances in micro/nanotechnologies for global control of hepatitis B infection

“…Co-infection of HBV with HCV and/or HIV causes a rapid progression to end-stage liver disease and death (Tuma et al, 2010). HBV infection is prevalent in 25% of HIV infected people (Hoffmann and Thio, 2007).…”