Treatment of Chronic Hepatitis B in the Human Immunodeficiency Virus--Infected Patient: Present and Future

Núñez, Marina; Puoti, Massimo; Camino, Nuria; Soriano, Vincent
December 2003
Clinical Infectious Diseases;12/15/2003, Vol. 37 Issue 12, p1678
Academic Journal
The management of chronic hepatitis B poses specific problems in the presence of human immunodeficiency virus (HIV) coinfection, because therapeutic approaches have to address both hepatitis B virus (HBV) and HIV infections. Response to interferon (IFN-α) is lower in HBV-HIV--coinfected than in HIV-negative subjects, especially in patients in advanced stages of immunosuppression. Thus far, there are no data on the performance of the new pegylated forms of IFN-α in HBV- and HIV--coinfected persons. After prolonged use of lamivudine, resistance develops in the majority of HBV-HIV--coinfected patients treated with the drug. The more recently approved tenofovir has shown excellent short-term results, and data from longer follow-up studies are eagerly awaited. Several drugs with combined anti-HIV and anti-HBV activity have recently been approved (emtricitabine) or are currently under development. Preliminary results with some of them are quite promising and probably will widen the therapeutic armamentarium against hepatitis B in patients with HIV infection.


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