Corcorran Maria A, Kim H Nina
Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
Curr HIV/AIDS Rep. 2023 Dec;20(6):451-457. doi: 10.1007/s11904-023-00670-0. Epub 2023 Oct 14.
Coinfection with HIV and hepatitis B virus (HBV) is common owing to shared routes of transmission, and persons with HIV-HBV coinfection experience an accelerated progression of liver disease. Despite the widespread availability of HBV vaccination, rates of seroprotection in people living with HIV (PLWH) have historically been low. In this article, we review strategies in HBV prevention among PLWH, focusing specifically on updates in HBV vaccination and chemoprophylaxis.
Vaccination remains the hallmark of HBV prevention, and recent studies suggest that a double dose of HBV vaccine and Heplisav-B can improve rates of seroprotection among PLWH. The use of tenofovir-containing antiretroviral therapy (ART) has similarly been shown to provide some HBV protection in PLWH; however, this protection can be lost when switching to newer tenofovir-sparing regimens, including long-acting injectables. All HBV-susceptible persons with HIV should be vaccinated against HBV, regardless of ART regimen and CD4 count.
由于传播途径相同，HIV与乙型肝炎病毒（HBV）合并感染很常见，且HIV-HBV合并感染患者的肝病进展会加速。尽管HBV疫苗已广泛可得，但HIV感染者（PLWH）的血清保护率历来较低。在本文中，我们综述了PLWH中HBV预防的策略，特别关注HBV疫苗接种和化学预防的最新进展。
疫苗接种仍然是HBV预防的关键，最近的研究表明，双倍剂量的HBV疫苗和Heplisav-B可提高PLWH的血清保护率。同样，使用含替诺福韦的抗逆转录病毒疗法（ART）已被证明可为PLWH提供一定的HBV保护；然而，当改用更新的无替诺福韦方案（包括长效注射剂）时，这种保护作用可能会丧失。所有对HBV易感的HIV感染者都应接种HBV疫苗，无论其ART方案和CD4细胞计数如何。
