Current management and recommendations on hepatitis B therapy in HIV-coinfected patients

[Guest guest]

http://www.springerlink.com/content/d00203535581243v/

Hepatology International

DOI: 10.1007/s12072-011-9292-9

Original Article

Current management and recommendations on hepatitis B therapy in HIV-coinfected

patients

Lionel Piroth, Sophie Mahy, Stanislas Pol, Fabrice Carrat, Damien Sene,

Etienne, Caroline Lascoux-Combe, Anne Simon, Jean-Luc Schmit and Patrice Cacoub,

et al.

Abstract

Background

The match between the real-life therapeutic management of chronic hepatitis B

(CHB) in HIV-infected patients and the recommendations that existed at the time

has never been assessed on a case-by-case basis.

Methods

A total of 73 HBV–HIV coinfected patients, 34 of whom were first followed in

2003–2005 and 39 in 2006–2008 (before and after the 2005 European Consensus

Conference on the treatment of chronic viral hepatitis in HIV coinfected

patients), were included. All the data were retrospectively collected from their

first visit to October 2008 through a standardised questionnaire.

Results

Baseline HBV DNA quantification and/or liver histology were missing in 44.1 and

28.2% of cases before and after 2005, respectively (p = 0.16). The observed

management significantly differed from the recommendations for the whole

population (p = 0.009), for the 2003–2005 group (p = 0.02), and tended to differ

for the 2006–2008 group (p = 0.07). Therapeutic management of CHB was in

accordance with the recommendations in 27 (57.4%) cases, with a higher rate of

untreated patients in the 2003–2005 group, and a high rate of patients on dual

therapy in both groups despite the fact that HBV therapy was not recommended.

Conclusion

Even though global management of HBV–HIV coinfected patients is improving,

baseline evaluation of CHB though necessary is still often insufficient. The

strong rationale for early dual anti-HIV and anti-HBV therapy, and the reality

of everyday clinical practice, bring support to the recent simplification of the

recommendations widening the use of tenofovir and emtricitabine in HBV–HIV

coinfected patients, irrespective of immunological, virological, or histological

considerations.

[Guest guest]

http://www.springerlink.com/content/d00203535581243v/

Hepatology International

DOI: 10.1007/s12072-011-9292-9

Original Article

Current management and recommendations on hepatitis B therapy in HIV-coinfected

patients

Lionel Piroth, Sophie Mahy, Stanislas Pol, Fabrice Carrat, Damien Sene,

Etienne, Caroline Lascoux-Combe, Anne Simon, Jean-Luc Schmit and Patrice Cacoub,

et al.

Abstract

Background

The match between the real-life therapeutic management of chronic hepatitis B

(CHB) in HIV-infected patients and the recommendations that existed at the time

has never been assessed on a case-by-case basis.

Methods

A total of 73 HBV–HIV coinfected patients, 34 of whom were first followed in

2003–2005 and 39 in 2006–2008 (before and after the 2005 European Consensus

Conference on the treatment of chronic viral hepatitis in HIV coinfected

patients), were included. All the data were retrospectively collected from their

first visit to October 2008 through a standardised questionnaire.

Results

Baseline HBV DNA quantification and/or liver histology were missing in 44.1 and

28.2% of cases before and after 2005, respectively (p = 0.16). The observed

management significantly differed from the recommendations for the whole

population (p = 0.009), for the 2003–2005 group (p = 0.02), and tended to differ

for the 2006–2008 group (p = 0.07). Therapeutic management of CHB was in

accordance with the recommendations in 27 (57.4%) cases, with a higher rate of

untreated patients in the 2003–2005 group, and a high rate of patients on dual

therapy in both groups despite the fact that HBV therapy was not recommended.

Conclusion

Even though global management of HBV–HIV coinfected patients is improving,

baseline evaluation of CHB though necessary is still often insufficient. The

strong rationale for early dual anti-HIV and anti-HBV therapy, and the reality

of everyday clinical practice, bring support to the recent simplification of the

recommendations widening the use of tenofovir and emtricitabine in HBV–HIV

coinfected patients, irrespective of immunological, virological, or histological

considerations.