Abstract
Worldwide there are 1300 million persons with chronic hepatitis B 40 million with HIV-1 infection and a substantial (but unknown) number with both. Available data indicate that ~8% of HIV-infected persons in the United States and Europe have chronic hepatitis B (i.e. HIV-hepatitis B virus [HBV] coinfection). The prevalence is higher among HIV-infected persons in some areas in sub-Saharan Africa and Asia although data are sparse. In several ways HIV-HBV coinfection adversely affects the chronic viral illnesses due to monoinfection with either virus. HIV-HBV-coinfected persons have more severe liver disease than do persons with either chronic infection alone. In the Multicenter AIDS Cohort Study the incidence of liver-related mortality for persons with HIV-HBV coinfection was 17 times that for HIV-uninfected persons with chronic hepatitis B. In addition HBV infection can affect the tolerability of antiretroviral medications. Wit et al. found that the incidence of grade 3-4 hepatotoxicity for HIV-HBV coinfected persons was 9 times the incidence for those without chronic hepatitis B a result corroborated by findings of other studies. (excerpt)
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