Ruta Simona, Grecu Laura, Iacob Diana, Cernescu Costin, Sultana Camelia
Virology Discipline, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Emerging Viral Diseases, "Stefan S. Nicolau" Institute of Virology, 030304 Bucharest, Romania.
Biomedicines. 2023 Apr 28;11(5):1306. doi: 10.3390/biomedicines11051306.
HIV-HBV coinfected patients have higher rates of liver-related morbidity, hospitalizations, and mortality compared to HBV or HIV mono-infected ones. Clinical studies have shown an accelerated progression of liver fibrosis and an increased incidence of HCC, resulting from the combined action of HBV replication, immune-mediated hepatocytolysis, and HIV-induced immunosuppression and immunosenescence. Antiviral therapy based on dually active antiretrovirals is highly efficient, but late initiation, global disparities in accessibility, suboptimal regimens, and adherence issues may limit its impact on the development of end-stage liver disease. In this paper, we review the mechanisms of liver injuries in HIV-HBV coinfected patients and the novel biomarkers that can be used for treatment monitoring in HIV-HBV coinfected persons: markers that assess viral suppression, markers for liver fibrosis evaluation, and predictors of oncogenesis.
与单纯感染乙肝病毒（HBV）或艾滋病毒（HIV）的患者相比，HIV-HBV合并感染患者的肝脏相关发病率、住院率和死亡率更高。临床研究表明，由于HBV复制、免疫介导的肝细胞溶解以及HIV诱导的免疫抑制和免疫衰老的共同作用，肝纤维化进程加速，肝癌发病率增加。基于双重活性抗逆转录病毒药物的抗病毒治疗效率很高，但治疗开始较晚、全球可及性差异、治疗方案欠佳以及依从性问题可能会限制其对终末期肝病发展的影响。在本文中，我们综述了HIV-HBV合并感染患者肝损伤的机制以及可用于HIV-HBV合并感染患者治疗监测的新型生物标志物：评估病毒抑制的标志物、肝纤维化评估标志物和肿瘤发生预测指标。
