Serological evidence of HBV infection has been found in up to
90% of patients with HIV infection, approximately 10% of whom
are chronically infected with HBV. Previous studies have shown
that HBV co-infection with HIV modifies the natural history of
HBV infection, resulting in higher HBV viral loads and increased
risk of progression to cirrhosis and hepatic decompensation, despite
reduced hepatic necroinflammatory activity and lower serum ALT
levels.
The nucleoside analogue, lamivudine, is almost invariably used
as a component of HAART ("highly active antiretroviral therapy")
or as an anti-HBV drug in this setting, in which development of
lamivudine resistance is common.
A study to investigate the natural history of hepatitis B and
viral lamivudine resistance in patients who are co-infected with
HBV and HIV is being carried out in collaboration with the Victorian
Infectious Diseases Service (Royal Melbourne Hospital) and the
Alfred Hospital.
