Management of chronic Hep B in HIV positive patients has improved

Management of chronic Hep B in HIV positive patients has improved

The latest issue of Journal of Hepatology reports on the management and treatment of chronic hepatitis B virus infection in HIV positive and negative patients.

Dr Lionel Piroth and colleagues from France compared the management and the virological and serological efficacy of treatments for chronic hepatitis B in HIV positive and negative patients.

The research team found that 246 HIV positive, and 205 HIV negative consecutive patients with past or present chronic hepatitis B, seen in 2008 in participating departments, were included in a multicenter study.

All the data were retrospectively collected from the first visit to 2008 through a standardized questionnaire.

Compared to HIV negative patients, HIV positive patients more often presented positive Hepatitis B e antigen, hepatitis B virus genotype A, co-infection with hepatitis C virus or hepatitis D virus.

The researchers found that HIV positive patients were more often on hepatitis B virus therapy, leading to undetectable serum hepatitis B virus DNA levels.
Hep B surface antigen loss was more often observed in HIV positive patients
Journal of Hepatology

In HIV positive patients, multivariate analysis showed that older age, lower initial hepatitis V virus DNA levels, and longer time on hepatitis B virus therapy significantly correlated with undetectable hepatitis B virus DNA.

The research team found no difference in efficacy between tenofovir used alone or in combination.
Hepatitis B surface antigen loss was more often observed in HIV positive patients, sometimes followed by hepatitis B surface antigen re-appearance after withdrawal of hepatitis B virus treatment.

The team noted that, excluding the 37 hepatitis B virus–hepatitis C virus-co-infected patients, the last clinical presentation and liver fibrosis scores were similar in HIV positive and negative patients.

Dr Piroth's team concludes, "The assessment of chronic Hepatitis B and the efficacy of hepatitis B virus therapy have improved in HIV positive patients."
"HIV infection did not have a negative impact on the likelihood of hepatitis B virus therapeutic success."
J Hepatol 2010: 53(6): 1006-1012
22 November 2010