Epidemiology

HIV no bar to hepatitis B therapy success

Last Updated: 2010-09-10 14:06:40 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - HIV infection doesn't have a negative impact on treatment of patients with hepatitis B (HBV) co-infection, French researchers report in an August 13th on-line paper in the Journal of Hepatology.

Dr. Lionel Piroth of CHU, Dijon, and colleagues came to this conclusion after retrospectively studying 246 HIV-positive and 205 HIV-negative patients who had or previously had chronic HBV infection.

Patients in the HIV group were significantly more likely to be infected with the HBV genotype A (54.8% versus 17.1%). They were also more likely to be hepatitis e antigen (HBeAg) positive (46.4% versus 32.8%).

Co-infection with hepatitis C and hepatitis delta virus was more prevalent in the HIV group. Nevertheless, they were more likely to be on HBV therapy (92.7% versus 57.1%) and to have undetectable levels of serum HBV DNA (71.0% versus 44.1%).

No difference in efficacy was seen when therapy was with tenofovir or in combination.

Excluding HBV-HCV-co-infected patients (31 HIV-positive and 6 HIV-negative), the last clinical presentation and liver fibrosis scores were similar in both groups.

HIV doesn't reduce the chances of therapeutic success, the researchers point out, and "HBV management, albeit still heterogeneous, is improving in HIV positive patients, and is now closer to that in HIV negative patients."

In fact, Dr. Piroth told Reuters Health by email, "apart from considerations directly linked to HIV therapy, chronic hepatitis B has to be assessed and managed in HIV co-infected patients as in HBV-monoinfected ones, with similar requirements. The negative impact of HIV on the evolution of untreated chronic hepatitis B is likely to disappear on efficient therapy."

SOURCE: http://link.reuters.com/pyt72p

J Hepatol 2010.