Matthews Gail
Viral Hepatitis Clinical Research Program, National Centre in HIV Epidemiology and Clinical Research, Sydney, New South Wales, Australia.
Curr Opin Infect Dis. 2007 Feb;20(1):16-21. doi: 10.1097/QCO.0b013e328012c5aa.
Coinfection with HIV and hepatitis B virus has a significant impact on the natural history of hepatitis B disease with faster rates of progression to cirrhosis and end stage liver disease. An increasing number of hepatitis B virus active drugs are now available, many of which have dual anti-HIV activity. This review highlights the most important recent developments in the management of HIV and hepatitis B virus coinfection.
Natural history studies continue to confirm the increased rate of liver-related mortality in coinfected individuals and the importance of hepatocellular carcinoma in this population. The most recent studies of adefovir and tenofovir in open label use in coinfected individuals are discussed and new data on the activity of emtricitabine, entecavir and pegylated interferon are presented. Strategies for use of these new options for anti-hepatitis B virus therapy in coinfected individuals are discussed.
Prevention of end stage liver disease and hepatocellular carcinoma in the coinfected population is vital and the increasing availability of drugs with potent anti-hepatitis B activity is encouraging. Appropriate diagnosis and monitoring of hepatitis B, coupled with better understanding of the mechanisms of drug resistance, will enable clinicians to manage coinfection more effectively.
HIV与乙型肝炎病毒合并感染对乙型肝炎疾病的自然病程有重大影响，会加快发展为肝硬化和终末期肝病的速度。目前有越来越多的乙型肝炎病毒活性药物可供使用，其中许多具有双重抗HIV活性。本综述重点介绍了HIV与乙型肝炎病毒合并感染管理方面最重要的近期进展。
自然史研究继续证实合并感染个体肝脏相关死亡率增加以及肝细胞癌在该人群中的重要性。讨论了阿德福韦和替诺福韦在合并感染个体中开放标签使用的最新研究，并展示了关于恩曲他滨、恩替卡韦和聚乙二醇化干扰素活性的新数据。讨论了在合并感染个体中使用这些抗乙型肝炎病毒治疗新选择的策略。
预防合并感染人群的终末期肝病和肝细胞癌至关重要，具有强效抗乙型肝炎活性的药物越来越多，这令人鼓舞。对乙型肝炎进行适当的诊断和监测，再加上对耐药机制的更好理解，将使临床医生能够更有效地管理合并感染。
