Abstract
Approximately 5 to 10% of human immunodeficiency virus- (HIV-) infected persons worldwide
have chronic hepatitis B virus (HBV). The management of these patients merits special
attention. They experience a faster progression to cirrhosis and more frequent liver-related
death than HBV-monoinfected individuals. For this reason, therapy for both HIV and
HBV is a priority in most cases. Some antivirals (i.e., tenofovir, lamivudine, emtricitabine)
are active against both viruses and should be part of the antiretroviral treatment
choice. However, drugs such as entecavir, telbivudine, or adefovir are active against
HBV and may display some residual activity against HIV, occasionally leading to the
selection of resistance mutations in the HIV polymerase, as is clearly shown with
entecavir. Thus, they should be used only in the context of potent antiretroviral
treatment. In this review, the authors will provide updated information on the natural
history of HIV/HBV coinfected patients, when and which drugs should be used in treatment,
and the concern about selection of drug resistance and vaccine escape mutants.
Keywords
HIV - chronic hepatitis B virus - drug resistance - lamivudine - tenofovir
