Management and treatment of chronic hepatitis B in HIV-positive patients

Figures & data

Table I. Main parameters to be assessed in HIV-infected patients with chronic hepatitis B.

	Baseline	Periodic monitoring
Liver enzymes	X	X
Hemogram	X	X
Biochemistry	X	X
HBV serological markers	X	X
Serum HBV-DNA	X	X
HBV genotype	X
HBV resistance		X^a
HDV antibody	X
HCV antibody	X
HAV antibody	X
Liver fibrosis staging	X	X
Abdominal ultrasound	X	X

^aIf virological failure on nucleos(t)ide analogues.

Figure 1. Treatment indication for chronic hepatitis B in HIV-infected individuals. Note: In patients with significant liver fibrosis (Metavir F2-F3), HBV treatment may be considered even when serum HBV-DNA is < 2000 IU/mL and liver enzymes are not elevated.

Figure 2. Treatment options for chronic hepatitis B in HIV-positive individuals (adapted from European AIDS Clinical Society Guidelines (8)).

Figure 3. Hepatitis B virus drug resistance mutations.

Figure 4. Strategies for safer lamivudine use in the treatment of chronic hepatitis B in resource-limited settings (adapted from Soriano and McMahon (59)). (A) add-on strategy; and (B) switch on strategy.

European AIDS Clinical Society Guidelines. Version 7.0. October 2013. Available at: http://www.europeanaidsclinicalsociety.org (accessed 6 March 2014).

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Soriano V, McMahon B. Rethinking therapeutic strategies for hepatitis B. Antivir Res. 2013;100:435–8.

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