HIV and Hepatitis B Virus Coinfection: Approach to Management: Case Study and Commentary.
J Clin Outcomes Manag
; 17(6): 273-286, 2010 Jun 01.
Article
en En
| MEDLINE
| ID: mdl-23761953
ABSTRACT
OBJECTIVE:
To review diagnosis and treatment in patients with HIV and hepatitis B virus (HBV) coinfection.METHODS:
Review of the literature in the context of a clinical case.RESULTS:
All patients with HIV should be screened for the presence of coinfection with HBV. Following diagnosis with HBV infection, the level of HBV activity should be assessed with testing for HBeAg, HBV DNA, and potentially a biopsy for staging the degree of fibrosis present. Based on the results of this workup, a decision regarding the role of anti-hepatitis treatment should be made. According to the latest chronic hepatitis B and HIV treatment guidelines, coinfected patients who require treatment for chronic hepatitis B should be started on a regimen that is fully active against both HIV and HBV. A first-line regimen for coinfected patients is generally composed of tenofovir and emtricitabine, plus one other agent active against HIV. In coinfected patients, durable responses are rare, and therefore patients are usually required to remain on therapy indefinitely.CONCLUSION:
Intensification of surveillance techniques and education programs should be developed to help prevent transmission of infection and integrate coinfected patients into the health care system. Once engaged in care, coinfected patients should receive treatment for both HIV and chronic hepatitis B with the goal of a decrease in liver failure, cirrhosis, hepatocellular carcinoma, and chronic hepatitis B-related mortality.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
4_TD
Problema de salud:
2_enfermedades_transmissibles
/
4_aids
Tipo de estudio:
Guideline
/
Prognostic_studies
Idioma:
En
Revista:
J Clin Outcomes Manag
Año:
2010
Tipo del documento:
Article