April 8, 2008

Hepatitis B Coinfection Doesn’t Affect HIV Treatment

People with HIV who are coinfected with chronic hepatitis B virus (HBV) respond just as well to antiretroviral (ARV) therapy as people without HBV coinfection, but do have higher death rates, according to a new study published in the May 2008 issue of HIV Medicine.

Previous research has demonstrated that people living with both HIV and HBV may have a more aggressive course of liver disease than HIV-negative people with HBV. What is less understood is whether people who are coinfected with both viruses respond as well to ARV treatment as people with just HIV infection, and whether treating HIV blunts HBV disease progression.

Lars Omland of the Department of Infectious Diseases, Rigshospitalet, in Copenhagen, Denmark, and his colleagues studied the medical records of a large cohort of people living with HIV in Denmark. The study included 3,180 people living with HIV who started ARV treatment between January 1995 and December 2006. Six percent of the participants were also infected with HBV, 87 percent were infected with only HIV, and 7 percent did not have data available to confirm or deny HBV infection and were classified as “unknown.”

Omland’s team found that people who were coinfected with HBV and HIV responded just as well to ARV treatment as people who were infected with just HIV. The two groups had similar CD4 cell increases and sustained control of HIV levels. There were 50 percent more deaths among people who were coinfected, however, and four times as many liver-related deaths.

These study results point to the need to effectively treat not just HIV, but also HBV, in people who are coinfected.

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