COMMENTARY

New Developments in the Management of Hepatitis B Virus/HIV Coinfection

Raymond T. Chung, MD

Disclosures

September 03, 2002

In This Article

Introduction

Since the introduction of potent antiretroviral therapy, HIV has been successfully converted from a uniformly fatal illness to a manageable chronic infection. Correspondingly, during the past 6 years the opportunistic infections that complicate profound immunosuppression have been replaced with newer forms of morbidity and even mortality. Chief among these has been the development of progressive liver disease due to hepatitis C virus (HCV) and hepatitis B virus (HBV). Because of their shared routes of transmission, HCV and HBV are frequently found in the HIV-infected host. While HCV coinfection has deservedly gained considerable attention as a major cause of mortality in the post-HAART era, complications of HBV-related liver disease are being increasingly recognized, especially as drug-resistant forms of HBV have become nearly universal in antiretroviral-experienced HIV-infected patients. This article will review the pathogenesis of HBV-related liver disease, diagnosis and screening strategies, current and forthcoming antiviral medications, and practical issues regarding the clinical management of HBV/HIV-coinfected patients.

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