Hepatitis B in HIV-infected patients

Clin Liver Dis. 2013 Aug;17(3):489-501. doi: 10.1016/j.cld.2013.05.008. Epub 2013 Jul 8.


Chronic hepatitis B virus (HBV) infection is common in HIV-positive individuals. Although HBV vaccination is mandatory for HIV-positive individuals with negative-HBV markers, lower rates of protection are achieved. HIV infection accelerates the course of liver disease caused by chronic HBV infection, leading to end-stage hepatic illness and increasing the risk of hepatocellular carcinoma. Anti-HBV active agents, especially tenofovir, improve outcomes. Lamivudine alone should be limited to patients with low serum HBV-DNA levels, since selection of drug resistance often compromises long-term benefits, leads to cross-resistance with other antivirals, and favors the potential emergence of HBV-vaccine escape mutants.

Keywords: Drug resistance; HBV vaccine; HBV-HIV coinfection; Hepatocellular carcinoma; Lamivudine; Liver fibrosis; Tenofovir.

Publication types

  • Review

MeSH terms

  • Adenine / analogs & derivatives
  • Adenine / therapeutic use
  • Anti-HIV Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Coinfection / drug therapy
  • Drug Resistance, Viral
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Hepatitis B Vaccines / therapeutic use
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / prevention & control
  • Hepatitis D / complications
  • Humans
  • Lamivudine / therapeutic use
  • Organophosphonates / therapeutic use
  • Tenofovir


  • Anti-HIV Agents
  • Antiviral Agents
  • Hepatitis B Vaccines
  • Organophosphonates
  • Lamivudine
  • Tenofovir
  • Adenine