Natural history of chronic hepatitis B in co-infected patients

摘要: HIV co-infection influences the course and natural history of hepatitis B virus (HBV) infection by impairing quantity quality innate adaptive immune response. The rates spontaneous resolution after acute anti-HBe anti-HBs seroconversions are decreased, levels HBV replication increased in HIV-infected patients. A more rapid progression liver fibrosis a higher rate cirrhosis decompensation (but not hepatocellular carcinoma) have been demonstrated co-infected risk HBV-associated end-stage disease liver-related mortality may be co-infection. Antiretroviral therapy trigger seroconversion and/or better control restoring immunity, but can also increase flares. Reactivation chronic has observed suspension anti-retrovirals with anti-HBV activity or occurrence resistance to lamivudine. Future research should focus on: impact HIV-induced changes response modifications induced anti-retroviral that on advanced B; association between genotype clinical disease; role occult as co-factor other causes injury.