Med. praxi. 2021;18(3):167-170 | DOI: 10.36290/med.2021.028

Specific features of viral hepatitis in patients with HIV infection

MUDr. Dan Veselý

AIDS centrum, Klinika infekčních, parazitárních a tropických nemocí, Nemocnice Na Bulovce, Praha

Klinika infekčních a tropických nemocí, 1. lékařská fakulta, Univerzita Karlova, Praha

Quite some time ago, several breakthroughs were achieved in the treatment of human immunodeficiency virus (HIV) infection which resulted in a significant improvement in the prognosis of HIV-positive patients, thus allowing to focus attention on primarily HIV-unrelated mortality factors. Hepatic mortality was shown to play a major role, particularly diseases caused by hepatitis B (HBV) and C viruses (HCV). Cases of coinfection with one or both viruses at the time of HIV diagnosis are very frequent, and subsequent cases of HIV reinfection are also very often detected. Generally, vaccination plays an important role in preventing HBV infection; however, its outcome in HIV-positive individuals is uncertain in this specific case. Consequently, the treatment of HBV infection in HIV-positive patients basically involves the inclusion of tenofovir in the combination of antiretroviral drugs. In terms of long-term persistence of antibodies to HCV and their delayed production in HIV-positive individuals, testing for the presence of HCV infection with the method of polymerase chain reaction (PCR) is essential. A transition from classic treatment of chronic HCV with interferon to the era of direct acting antivirals (DAA) currently enables a safe, uncomplicated, and universally effective treatment of coinfected patients, in fact, regardless of the degree of liver disease.

Keywords: coinfection, HIV, HCV, HBV.

Published: September 2, 2021  Show citation