[Human immunodeficiency virus infection and viral hepatitis]

Enferm Infecc Microbiol Clin. 2011 Nov;29(9):691-701. doi: 10.1016/j.eimc.2011.07.003. Epub 2011 Oct 5.
[Article in Spanish]

Abstract

Hepatic complications currently represent one of the leading reasons for medical consultations, hospitalisation, and death in the HIV-infected population. This is due to a large extent to viral hepatitis, given its disproportionate frequency in this population. Chronic hepatitis B affects 5-10% of the HIV-infected population. Vaccination has reduced the incidence of liver disease related to hepatitis-B virus (HBV), and the availability of tenofovir has dramatically improved the prognosis of HIV/HBV carriers. Delta hepatitis affects around 15% of HIV-infected individuals in Europe harbouring positive HBsAg. It has the worst prognosis, given its accelerated course to cirrhosis and the absence of successful therapy. Lastly, chronic hepatitis C is the major cause of liver disease in the HIV population. Although classically linked to persons infected parenterally (i.e., intravenous drug users), outbreaks of acute hepatitis C among homosexual men have been reported over the last decade. Treatment with pegylated interferon plus ribavirin provides a cure in less than 40% of patients. However, the introduction of new direct acting antivirals against hepatitis- C virus (HCV) (telaprevir, boceprevir) has revolutionised the field, as HAART did in 1996 in the HIV field, improving the prognosis of co-infected patients. However, interactions between these drugs and antiretroviral agents and the risk of selective resistance pose huge threats in this population.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Algorithms
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / pharmacology
  • Anti-HIV Agents / therapeutic use
  • Antiviral Agents / adverse effects
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use
  • Comorbidity
  • Disease Progression
  • Drug Interactions
  • Drug Monitoring
  • Drug Resistance, Viral
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Hepatitis B / complications
  • Hepatitis B / drug therapy
  • Hepatitis B / epidemiology
  • Hepatitis C / complications
  • Hepatitis C / drug therapy
  • Hepatitis C / epidemiology
  • Hepatitis D / complications
  • Hepatitis D / drug therapy
  • Hepatitis D / epidemiology
  • Hepatitis, Viral, Human / complications*
  • Hepatitis, Viral, Human / drug therapy
  • Hepatitis, Viral, Human / epidemiology
  • Humans
  • Male
  • Prognosis
  • Recurrence

Substances

  • Anti-HIV Agents
  • Antiviral Agents