Natural history of chronic hepatitis B in co-infected patients

Puoti, Massimo; Torti, Carlo; Bruno, Raffaele; Filice, G.; Carosi, Giampiero

doi:10.1016/j.jhep.2005.11.015

Cited by 198 publications

(152 citation statements)

References 62 publications

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“…In chronic HCV patients on hemodialysis, the prevalence of occult HBV infection is not yet well known [22,24]. Some studies have demonstrated that HIV infection modifies the natural history of HBV and HCV infections [25], increasing the progression to chronic disease. Among immunocompromised patients, HBV-DNA can be detected in 10% of HBsAg negative/anti-HBc positive patients.…”

Section: Discussionmentioning

confidence: 99%

Occult hepatitis B virus infection in immunocompromised patients

Jardim¹,

Gonçales²,

Pereira³

et al. 2008

Braz J Infect Dis

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Occult hepatitis B infection is characterized by hepatitis B virus (HBV) DNA in the serum in the absence of hepatitis B surface antigen (HBsAg). We assessed occult HBV infection prevalence in two groups of immunocompromised patients (maintenance hemodialysis patients and HIV-positive patients) presenting HBsAgnegative and anti-HBc positive serological patterns, co-infected or not by HCV. Thirty-four hemodialysis anti-HIV negative patients, 159 HIV-positive patients and 150 blood donors who were anti-HBc positive (control group) were selected. HBV-DNA was detected by nested-PCR. Occult hepatitis B infection was not observed in the hemodialysis patients group but was found in 5% of the HIV-patients and in 4% of the blood donors. Immunosuppression in HIV positive patients was not a determining factor for occult HBV infection. In addition, no significant relationship between HBV-DNA and HCV co-infection in the HIV-positive patient group was found. A lack of significant associations was also observed between positivity for HBV-DNA and CD4 count, viral load and previous lamivudine treatment in these HIV-positive patients.

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Section: Discussionmentioning

confidence: 99%

Occult hepatitis B virus infection in immunocompromised patients

Jardim¹,

Gonçales²,

Pereira³

et al. 2008

Braz J Infect Dis

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“…A more rapid progression of liver fibrosis and a higher rate of hepatic decompensation on cirrhosis (but not HCC) have been demonstrated in concurrently infected patients [25,26]. The risk of HBV-associated end-stage liver disease and liver-related mortality may be increased in HIV concurrent infection [26,27].…”

Section: Hbv and Hdvmentioning

confidence: 99%

Current therapy for hepatitis C or D or immunodeficiency virus concurrent infection with chronic hepatitis B

Chien

2008

Hepatol Int

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Concurrent hepatitis C virus (HCV), hepatitis delta virus (HDV), or human immunodeficiency virus (HIV) infection with chronic hepatitis B virus (HBV) appears to increase the risk of progressive liver disease including liver cirrhosis and hepatocellular carcinoma. There is a 10% prevalence of HCV infection in chronic HBV or HDV infection. Serological evidence of previous exposure to HBV is found in more than 80% of HIVpositive patients in the high risk group. Notably, the most recently acquired virus tends to suppress the pre-existing virus. In chronic HBV infection acquired perinatally or in early childhood, usually HCV is dominant and may suppress or even displace HBV and HDV. Less frequently, HBV or HDV suppresses HCV. It is generally agreed that the dominant virus should be identified in order to make appropriate treatment decisions. Studies with standard interferon (IFN) to treat patients with HCV dominantly dual HBV/HCV infection have showed only limited virological response. But high dose of IFN has been demonstrated with better response rate. Combined ribavirin with standard or pegylated IFN therapy could achieve a sustained HCV clearance rate comparable with those infected with HCV alone. On the contrary, patients with HBV dominantly dual viral infection might indicate more appropriate addition of lamivudine to IFN than ribavirin. Additionally, patients with concurrent infection of HBV and HDV, IFN seems to be the only effective agent. However, the efficacy of IFN is related to the dose. High dose of IFN [9 MU tiw (thrice per week)] and longer treatment duration (at least 2 years) have been shown to achieve adequate virological response. In patients with concurrently infected HBV and HIV, anti-HBV therapy should be considered for all patients with evidence of liver disease, irrespective of the CD4 cell count. In patients not requiring antiretroviral therapy, HBV therapy should be preferentially based on IFN, adefovir, or telbivudine. In contrast, in patients with CD4 cell counts \350 cells/ll or those already on antiretroviral therapy, agents with double anti-HBV and anti-HIV activity are preferred. At present, the evidence of therapeutic efficacy is not sufficient to make a recommendation in treating patients with dual HBV/HCV or HBV/HDV or HBV/HIV infection. Further studies of the well-designed, larger scale are needed to elucidate the role of different regimens or combination in the treatment of dual viral infection.

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“…38 Because maternal HIV coinfection correlates with higher HBV viral load, which is also a major determinant of HBV MTCT risk, interventions to prevent MTCT of HBV may be of even greater impact in regions of higher HIV prevalence. [39][40][41] Where such interventions are available, realization of HBV status through screening has substantial value.…”

mentioning

confidence: 99%

Prevalence of Hepatitis B and Hepatitis C Coinfections in an Adult HIV Centre Population in Gaborone, Botswana

Patel¹,

Davis

Tolle³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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The objective of this study was to assess the prevalence of hepatitis B and hepatitis C coinfections in human immunodeficiency virus (HIV) -infected adults at an HIV center in Gaborone, Botswana. A retrospective review was performed of charts of currently active HIV-infected adult patients in the Family Model Clinic (FMC) of the Botswana-Baylor Children's Clinical Center of Excellence (BCOE) in Gaborone, Botswana, for the results of serum hepatitis B surface antigen (HBsAg) and antihepatitis C IgG tests performed between January 1, 2005 and December 15, 2009. Of 308 active FMC patients, 266 underwent HBsAg serology testing within the period of study. The HBsAg coinfection prevalence was 5.3% (14/266); 2 of 252 patients had at least one positive antihepatitis C IgG serology, a 0.8% prevalence. Hepatitis B coinfection is relatively common in HIV-infected adults at our center in Botswana, whereas hepatitis C coinfection is rare. In this setting, where the diagnosis of hepatitis B coinfection with HIV has implications for choice of first-line antiretroviral therapy and prevention of perinatal hepatitis B transmission, broader sampling to establish the true population prevalence of hepatitis B coinfection and the desirability of adding screening to HIV management should be considered. These findings provide little justification for adding hepatitis C coinfection screening to the management of HIV infection in Botswana.

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Natural history of chronic hepatitis B in co-infected patients

Cited by 198 publications

References 62 publications

Occult hepatitis B virus infection in immunocompromised patients

Occult hepatitis B virus infection in immunocompromised patients

Current therapy for hepatitis C or D or immunodeficiency virus concurrent infection with chronic hepatitis B

Prevalence of Hepatitis B and Hepatitis C Coinfections in an Adult HIV Centre Population in Gaborone, Botswana

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