Abstract
Chronic hepatitis B virus (HBV) infection, which affects 7%-10% of HIV-infected patients, is associated with an increased frequency of AIDS-related and non-AIDS-related clinical endpoints, such as end-stage liver diseases including cirrhosis and hepatocellular carcinoma. Broad access to a very efficient antiviral therapy containing nucleos(t)ide analogues with dual activity against HBV and HIV reverse transcriptases has initiated a transition in the paradigm of HBV control in the context of HIV-induced immunosuppression. The control of viral replication is not currently such a problem, but preventing the emergence of HBV polymerase and surface gene mutants after prolonged exposure to nucleos(t)ides and their consequences in terms of HBV vaccine escape are the next long-term challenges. Another challenge is the prevention of end-stage liver disease in an ageing population, in whom non-invasive markers of liver fibrosis, although used more frequently as a substitute for liver biopsy, are not the panacea. Finally, access to prevention, diagnosis, care and treatment of HBV infection remains a major issue in developing countries, including most regions of Africa and Asia, where HBV is endemic and the epidemic of HIV infection is still thriving. © The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.
Original language | English |
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Pages (from-to) | 10-17 |
Number of pages | 8 |
Journal | The Journal of antimicrobial chemotherapy |
Volume | 65 |
Issue number | 1 |
DOIs | |
Publication status | Published - 8 Nov 2009 |
Externally published | Yes |
Keywords
- Africa
- Animals
- Anti-HIV Agents/therapeutic use
- Antiviral Agents/therapeutic use
- Asia
- Case Management
- HIV Infections/complications
- Hepatic Insufficiency/etiology
- Hepatitis B, Chronic/complications
- Humans