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Viral hepatitis and HIV coinfection |
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Mark S. Sulkowski
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Cumartesi, 02 Mayıs 2009 |
Okunma: 1354 kez
Persons at high risk for human immunodeficiency virus (HIV) infection are also likely to be at risk for other infectious pathogens, including hepatitis B virus (HBV) or hepatitis C virus (HCV). These are bloodborne pathogens transmitted through similar routes; for example, via injection drug use (IDU), sexual contact, or from mother to child during pregnancy or birth.
Persons at high
risk for human immunodeficiency virus (HIV) infection are also likely
to be at risk for other infectious pathogens, including hepatitis B
virus (HBV) or hepatitis C virus (HCV). These are bloodborne pathogens
transmitted through similar routes; for example, via injection drug use
(IDU), sexual contact, or from mother to child during pregnancy or
birth. In some settings, the prevalence of coinfection with HBV and/or
HCV is high. In the context of effective antiretroviral therapy (ART),
liver disease has emerged as a major cause of morbidity and mortality
in HIV-infected persons. Further, coinfection with viral hepatitis may
complicate the delivery of ART by increasing the risk of drug-related
hepatoxicity and impacting the selection of specific agents (e.g.,
those dually active against HIV and HBV). Expert guidelines developed
in the United States and Europe recommend screening of all HIV-infected
persons for infection with HCV and HBV and appropriate management of
those found to be chronically infected. Treatment strategies for HBV
infection include the use of nucleos(t)ide analogues with or without
anti-HIV activity and/or peginterferon alfa (PegIFN) whereas HCV
treatment is limited to the combination of PegIFN and ribavirin (RBV).
Current approaches to management of HIV-infected persons coinfected
with HBV or HCV are discussed in this review.

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Viral hepatitis and HIV coinfection
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