The course and treatment of chronic hepatitis B in HIV-infected patients


The paper reviews the data available in the literature on patients with mixed hepatitis B virus (HBV) and HIV infection, its course and outcomes. The unity of the mechanisms of contamination with HBV and HIV increases the likelihood of these infections in patients. About 70% of HIV-infected patients are carriers of the markers, the presence of which is indicative of current or previous HBV infection. An average of 7.6% of HIV-infected patients were diagnosed as having chronic hepatitis B (CHB) in West Europe and North America. The notification rate of CHB in adult HIV-infected patients was 5-7% in the Russian Federation. Most specialists report that HIV-infected patients have a severer course of HBV. Mixed HBV and HIV infection, and low CD4+ lymphocyte count in particular, increase the risk for death from hepatic diseases and there is evident hepatotoxicity during antiretroviral therapy. The management of patients with mixed HBV and HIV infection is determined by indications for therapy for both HIV infection and CHV infection, by the availability of double-action antiviral drugs (that suppress either HIV or HBV replication), by the development of their resistance in one or both viruses. Indications and preferable variants of using various treatment regimens are given.

About the authors

Semen Leonidovich Maksimov


Svetlana Pavlovna Tsarenko


Aleksey Viktorovich Kravchenko


Nikolay Dmitrievich Yushchuk

S L Maksimov

Moscow State University of Medicine and Dentistry

Moscow State University of Medicine and Dentistry

S P Tsarenko

Moscow State University of Medicine and Dentistry

Moscow State University of Medicine and Dentistry

A V Kravchenko

Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

N D Yushchuk

Moscow State University of Medicine and Dentistry

Moscow State University of Medicine and Dentistry


  1. Goldstein S. T., Zhou F., Hadler S. C. et al. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int. J. Epidemiol. 2005; 34(6): 1329.
  2. Резолюция первой Европейской согласительной конференции по лечению хронических гепатитов B и C у ВИЧ-инфицированных. Стандарты медицины 2006; 1: 39-48.
  3. Mauss S., Berg F., Rockstroh J., Sarrazin C., eds. Wedermeyer H.; Hepatology. A clinical textbook. 2nd ed. Dusseldorf, 2010.
  4. Ющук Н. Д., Венгеров Ю. Я. (ред.) Лекции по инфекционным болезням. М.; 2007. 592-608.
  5. Lee W. M. Hepatitis B virus infection. N. Engl. J. Med. 1997; 337(24): 1733-1745.
  6. Lee H., Park W. Public health policy for management of hepatitis B virus infection: historical review of recommendations for immunization. Publ. Hlth Nurs. 2010; 27(2): 148-157.
  7. Custer B., Sullivan S., Hazlet Th. et al. Global epidemiology of hepatitis B virus. J. Clin. Gastroenterol. 2004; 38: 158-168.
  8. Хронический гепатит B: практические рекомендации Американской ассоциации по изучению заболеваний печени. Рос. журн. гастроэнтерол., гепатол., колопроктол. 2008; 1: 4-25.
  9. Thio C. Hepatitis B in the HIV-infected patient: epidemiology, natural history and treatment. Semin. Liver Dis. 2003; 23: 125-136.
  10. Alter M. J. Epidemiology of viral hepatitis and HIV coinfection. J. Hepatol. 2006; 44 (Suppl. 1): 6-9.
  11. Shao J., Haukenes G., Yangi E., Vollset S. Association of hepatitis B and HIV infections in Tanzanian population groups. Eur. J. Clin. Microbiol. Infect. Dis. 1993; 12: 62-64.
  12. Uneke C., Ogbu O., Inyama P. et al. Prevalence of hepatitis-B surface antigen among blood donors and HIV-infected patients in Jos, Nigeria. Mem. Inst. Oswaldo Cruz 2005; 100: 13-16.
  13. Кравченко А. В., Ганкина Н. Ю., Канестри В. Г., Максимов С. Л. Тактика лечения хронического гепатита B у больных ВИЧ-инфекцией. Инфекц. бол. 2008; 2: 88-95.
  14. Detering K., Constantinescu I., Nedelcu F. D. et al. Prevalence of HBV genotypes in Central and Eastern Europe. J. Med. Virol. 2008; 80(10): 1707-1711.
  15. Генетическая изменчивость вирусов гепатита человека и ее клиническое значение / Ющук Н. Д., Знойко О. О., Климова Е. А. и др. М.; 2007.
  16. Perez-Olmeda M., Nunez M., Garcia-Samaniego J. et al. Distribution of HBV genotypes in HIV-infected patients with chronic hepatitis B: therapeutic implications. AIDS Res. Hum. Retrovirus. 2003; 19: 657-659.
  17. Koibuchi T., Hitani A., Nakamura T. et al. Predominance of genotype A HBV in an HBV/HIV-1 dually positive population compared with an HIV-1-negative counterpart in Japan. J. Med. Virol. 2001; 64: 435-440.
  18. Kellerman S., Hanson D., McNaghten A., Fleming P. Prevalence of chronic hepatitis B and incidence of acute hepatitis B infection in HIV-infected subjects. J. Infect. Dis. 2003; 188: 571- 577.
  19. Hadler S. C., Judson F. N., O'Malley P. et al. Outcame of HBV infection in homosexual men and its relation to prior HIV infection. J. Infect. Dis. 1991; 163: 454-459.
  20. Bodsworth N., Cooper D., Donovan B. The influence of HIV-1 infection on the development of the hepatitis B carrier state. J. Infect. Dis. 1991; 163: 1138-1140.
  21. Konopnicki D., Mocroft A., de Wit S. et al. Hepatitis B and HIV: prevalence, AIDS progression, response to highly active antiretroviral therapy and increased mortality in the EuroSIDA cohort. AIDS 2005; 19(6): 593-602.
  22. Puoti M., Raffaele B., Soriano V. et al. Hepatocellular carcinoma in HIV-infected patients: epidemiological features, clinical presentation and outcome. AIDS 2004; 18(17): 2285-2293.
  23. Soriano V., Permanyer P., eds. HIV and viral hepatitis coinfection. 2007. Barselona.
  24. Sulkowski M. S. Viral hepatitis and HIV coinfection. J. Hepatol. 2008; 48: 353-367.
  25. Soriano V., Puoti M., Bonacini M. et al. Care of patients with chronic hepatitis B and HIV coinfection: recommendations from an HIV-HBV international panel. AIDS 2005; 19(3): 221-240.
  26. Centres for Disease Control and Prevention. Recommendations for follow-up of healthcare workers after occupational exposure to HCV, J. A. M. A. 1997; 278: 1056-1057.
  27. Lamagni T., Davison K., Hope V. et al. Poor hepatitis B vaccine coverage in injecting drug user: England, 1995 and 1996. Common. Dis. Publ. Hlth 1999; 2: 174-177.
  28. Rey D., Krantz V., Partisani M. et al. Increasing the number of hepatitis B vaccine injections augments anti-HBs response rate in HIV infected patients. Effects on HIV-1 viral load. Vaccine 2000; 18: 1161-1165.
  29. Fonseca M., Pang L., de Paula C. et al. Randomized trial of recombinant hepatitis B vaccine in HIV-infected adult patients comparing a standard dose to a double dose. Vaccine 2005; 23: 2902-2908.
  30. Chen C. J., Yang H. I., Su J. et al. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. J. A. M. A. 2006; 295(1): 65-73.
  31. Канестри В. Г., Кравченко А. В., Ганкина Н. Ю. и др. Гепатотоксичность у больных ВИЧ-инфекцией, получавших высокоактивную антиретровирусную терапию. Эпидемиол. и инфекц. бол. 2006; 6: 31-34.
  32. Саламов Г. Г., Деткова Н. В. ВИЧ-инфекция, вирусные гепатиты и сифилис у лиц, занимающихся проституцией. Эпидемиол. и инфекц. бол. 2001; 1: 56-57.
  33. Диспансерное наблюдение, лечение и профилактика вирусных гепатитов у подростков и взрослых, больных ВИЧ-инфекцией: Метод. рекомендации / Кравченко А. В., Ганкина Н. Ю., Канестри В. Г. и др. М.; 2007.
  34. Rockstroh J. K., Bhagani S., Benhamou Y. et al. European AIDS Clinical Society (EACS) guidelines for the clinical management and treatment of chronic hepatitis B and C coinfection in HIV-infected adults. HIV Med. 2008; 9: 82-88.
  35. Clinical management and treatment of HIV-infected adults in Europe. European AIDS Clinical Society (EACS) Guidelines; Version 5, November 2009: (
  36. Audsley J., Sasadeusz J., Mijh A. et al. The Anti-HIV activity of entecavir: Serum HIV RNA decreases and selection of the M184V mutation occurs in both ART-naive and -experienced HIV/HBV-co-infected individuals. 15-th Conference on retroviruses and opportunistic infections (CROI). Boston, USA, 2008. Boston; 2008. Abstr. 63.
  37. McMahon M. A., Jilek B. L., Brennan T. P. et al. The HBV drug entecavir - effects on HIV-1 replication and resistance. N. Engl. J. Med. 2007; 356(25): 2614-2621.
  38. Покровский В. В. (ред.) ВИЧ-инфекция и СПИД. 2-е изд. М.: ГЭОТАР-Медиа; 2010.
  39. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Developed by the Panel on Clinical Practices for Treatment of HIV Infection convened by the Department of Health and Human Services (DHHS); December 1, 2009: (
  40. Исаков В. А. Современная стратегия лечения хронического гепатита B: достижения и перспективы. Экспер. и клин. гастроэнтерол. 2007; 2: 3-8.
  41. Lai C. L., Gane E., Hsu C. W. et al. Two-year results from the GLOBE trial in patients with hepatitis B: greater clinical and antiviral efficacy for telbivudine vs lamivudine. Hepatology 2006; 44: 222A, Abstr. 91.
  42. Benhamou Y., Bochet M., Thibault V. et al. Long-term incidence of hepatitis B virus resistance to lamivudine in HIV-infected patients. Hepatology 1999; 30: 1302-1306.
  43. Gallant J. E., Parish M. A., Keruly J. C., Moore R. D. Changes in renal function associated with tenofovir disoproxil fumarate treatment, compared with nucleoside reverse-transcriptase inhibitor treatment. Clin. Infect. Dis. 2005; 40: 1194-1198.
  44. Cassetti I., Madruga J. V., Etzel A. et al. The safety and efficacy of tenofovir DF (TDF) in combination with lamivudine (3TC) and efavirenz (EFV) in antiretroviral-naive patients through seven years. In: Program and abstracts of the 17-th International AIDS conference, Aug. 3-8 2008: Mexico City, Mexico. Mexico City; 2008. Abstr. TUPE0057.



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Copyright (c) 2010 Maksimov S.L., Tsarenko S.P., Kravchenko A.V., Yushchuk N.D., Maksimov S.L., Tsarenko S.P., Kravchenko A.V., Yushchuk N.D.

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