Review
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World J Gastroenterol. Dec 14, 2014; 20(46): 17360-17367
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17360
Hepatitis B and human immunodeficiency virus co-infection
Bao-Chau Phung, Philippe Sogni, Odile Launay
Bao-Chau Phung, Philippe Sogni, Odile Launay, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
Bao-Chau Phung, Odile Launay, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, 75014 Paris, France
Bao-Chau Phung, Odile Launay, Inserm, CIC1417, 75014 Paris, France
Philippe Sogni, APHP, Hôpital Cochin, Service d’hépatologie, 75014 Paris, France
Author contributions: Phung BC wrote the paper; Launay O and Sogni P reviewed it.
Correspondence to: Odile Launay, MD, PhD, Professor, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Groupe Hospitalier Cochin - Saint, Vincent de Paul, 27 rue du Faubourg St Jacques, 75014 Paris, France. odile.launay@cch.aphp.fr
Telephone: +33-1-58412858 Fax: +33-1-58412910
Received: February 12, 2014
Revised: April 17, 2014
Accepted: July 22, 2014
Published online: December 14, 2014
Processing time: 306 Days and 18.8 Hours
Abstract

Hepatitis B and human immunodeficiency virus (HBV and HIV) infection share transmission patterns and risk factors, which explains high prevalence of chronic HBV infection in HIV infected patients. The natural course of HBV disease is altered by the HIV infection with less chance to clear acute HBV infection, faster progression to cirrhosis and higher risk of liver-related death in HIV-HBV co-infected patients than in HBV mono-infected ones. HIV infected patients with chronic hepatitis B should be counseled for liver damage and surveillance of chronic hepatitis B should be performed to screen early hepatocellular carcinoma. Noninvasive tools are now available to evaluate liver fibrosis. Isolated hepatitis B core antibodies (anti-HBc) are a good predictive marker of occult HBV infection. Still the prevalence and significance of occult HBV infection is controversial, but its screening may be important in the management of antiretroviral therapy. Vaccination against HBV infection is recommended in non-immune HIV patients. The optimal treatment for almost all HIV-HBV co-infected patients should contain tenofovir plus lamivudine or emtricitabine and treatment should not be stopped to avoid HBV reactivation. Long term tenofovir therapy may lead to significant decline in hepatitis B surface Antigen. The emergence of resistant HBV strains may compromise the HBV therapy and vaccine therapy.

Keywords: Chronic hepatitis B; Human immunodeficiency virus; Management; Occult hepatitis; Treatment

Core tip: Hepatitis B and human immunodeficiency virus (HBV and HIV) infection share transmission patterns and risk factors, which explains high prevalence of chronic HBV infection in HIV infected patients. The natural course of HBV disease is altered by the HIV infection with less chance to clear acute HBV infection, faster progression to cirrhosis and higher risk of liver -related death in HIV-HBV co-infected patients than in HBV mono-infected ones. The management of HBV co-infection in HIV infected persons remains a challenge. This review provides update on epidemiology, natural history, diagnosis, prevention and treatment of hepatitis B infection in HIV infected patients.