Hepatitis & HIV

Depending on the type of hepatitis different aspects concerning the coinfection with hepatitis and HIV are relevant.

For instance, a coinfection with HBV is normally treated simultaneously with antiretroviral therapy, as some drugs used in HIV therapy are also active against the hepatitis B virus.

However, it is important to consider hepatitis B if changes in HIV therapy are made. Discontinuing HIV drugs which are also effective against hepatitis B without adequate replacement can cause a flare of the hepatitis B infection and a worsening of the liver desease.

HCV/HIV coinfection is more difficult to treat. Nevertheless, antiretroviral therapy can at least partially prevent liver-related complications.

HBV/HIV coinfection

Today, HBV infection is easier to deal with than in the past, as some antiretroviral drug also effectially inhibit the replication of HBV. These drugs are

  • tenofovir
  • emtricitabine
  • lamivudine

As a result HBV infection can usually be controlled well, in particular in patients treated with tenofovir, although the development of resistances may complicate the longterm therapy of hepatitis B.

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HCV/HIV coinfection

Treatment of hepatitis C with interferon free all oral medications is as effective in HIV-coinfected as in HCV-monoinfected patients usually achieving viral cure in >95% of treated patients (see Hepatitis | Diagnosis & treatment ).

Antiretroviral therapy in HIV/HCV coinfected patients

Cohort studies in HIV /HCV coinfected patients show a more favourable course of liver disease in patients receiving antiretroviral therapy. Antiretrovirally treated patients suffer less from severe complications of their liver disease than coinfected patients without antiretroviral treatment. Most of the effect may be due to the improvement of the immune system after the control of HIV.

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