Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 16: Is There A Simple Way To Treat A Patient Who Is Coinfected With Hepatitis B Virus And Hiv? (continued)

Richard K. Sterling, MD, MSc, FACP, FACG

The simple answer to this question is yes and no. The majority of those infected with human immunodeficiency virus (HIV) have been exposed to hepatitis B virus (HBV). Before you think about initiating anti-HBV therapy, you need to understand the epidemiology and natural history of HBV in those with HIV. Only then can you consider the treatment options. Similar to coinfection of HIV and HCV, with shared modes of transmission, there is also concern over the liver-related health risks of HBV-HIV, which were previously overshadowed by the morbidity and mortality of HIV until the introduction of…