HIV and hepatitis B virus co-infection

Different studies have found varying HIV/hepatitis B co-infection rates. In the EuroSIDA cohort, 9% were infected with both viruses.1 Studies of hepatitis B infection in gay men, injecting drug users and people with haemophilia have shown that hepatitis B infection does not hasten HIV disease progression or severity, but does increase the risk of death.2 3 4 A study of patients in the Multicenter AIDS Cohort found that men who were hepatitis B surface antigen-positive were eight times more likely to die of liver-related causes when compared to men with HIV who did not have hepatitis B.5 

Conversely, research shows that being co-infected with HIV does increase the chances that a person exposed to hepatitis B virus will develop chronic hepatitis B. It also accelerates liver disease progression and increases the risk that a co-infected person will develop cirrhosis or hepatocellular carcinoma (liver cancer). HIV co-infection also appears to impair the response to anti-hepatitis B treatment. A meta-analysis of all reported studies found that coinfected individuals had a 36% higher risk of death from any cause, but did not have an elevated risk of progression to AIDS.6

References

  1. Konopnicki D et al. Hepatitis B and HIV: prevalence, AIDS progression, response to highly active antiretroviral therapy and increased mortality in EuroSIDA. AIDS 19: 593-601, 2005
  2. Gilson RJC et al. Interactions between HIV and hepatitis B virus in homosexual men: effects on the natural history of infection. AIDS 11: 597-606, 1997
  3. Hadler SC et al. Outcome of hepatitis B virus infection in homosexual men and its relation to prior human immunodeficiency virus infection. J Infect Dis 163: 454-459, 1991
  4. Sinicco A et al. Coinfection and superinfection of hepatitis B virus in patients infected with human immunodeficiency virus: no evidence of faster progression to AIDS. Scan J Infect Dis 29: 111-115, 1997
  5. Thio CL et al. Liver disease mortality in HIV-HBV co-infected persons. Ninth Conference on Retroviruses and Opportunistic Infections, Seattle, abstract 656, 2002
  6. Nikolopoulos GK et al. Impact of hepatitis B virus infection on the progression of AIDS and mortality in HIV-infected individuals: a cohort study and meta-analysis. Clin Infect Dis 48(12):1763-71, 2009
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