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Article

Strategies for managing coinfection with hepatitis B virus and HIV

William D. Carey, MD and Morris Sherman, MD, PhD
Cleveland Clinic Journal of Medicine May 2009, 76 (5 suppl 3) S30-S33; DOI: https://doi.org/10.3949/ccjm.76.s3.07
William D. Carey
Cleveland Clinic
Roles: Supplement Editor
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Morris Sherman
Associate Professor of Medicine, University of Toronto University Health Network Toronto, ON, Canada
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ABSTRACT

Hepatitis B virus (HBV) infection is more aggressive in individuals coinfected with human immunodeficiency virus (HIV): in the presence of HIV, HBV carrier rates and viremia levels are higher, episodes of activation are more frequent, cirrhosis progresses more quickly, and hepatocellular carcinoma occurs more often than with HBV infection alone. As in HBV monotherapy, the objective of treatment is suppression of viral replication. Standard or pegylated interferon may be appropriate treatment for chronic HBV infection for patients who have not yet started highly active antiretroviral therapy (HAART) for their HIV. When treatment is required for both diseases, the use of a combination of nucleoside and nucleotide analogues is prudent, with careful selection of therapy to reduce the risk of antiviral resistance—a particular concern for patients receiving antiretroviral therapy for both HIV and HBV. HBV DNA levels should be monitored every 3 months; the frequency can be extended to every 6 months once the viral load becomes stable or undetectable.

  • Copyright © 2009 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 76 (5 suppl 3)
Cleveland Clinic Journal of Medicine
Vol. 76, Issue 5 suppl 3
1 May 2009
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Strategies for managing coinfection with hepatitis B virus and HIV
William D. Carey, Morris Sherman
Cleveland Clinic Journal of Medicine May 2009, 76 (5 suppl 3) S30-S33; DOI: 10.3949/ccjm.76.s3.07

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Strategies for managing coinfection with hepatitis B virus and HIV
William D. Carey, Morris Sherman
Cleveland Clinic Journal of Medicine May 2009, 76 (5 suppl 3) S30-S33; DOI: 10.3949/ccjm.76.s3.07
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