in partnership with Hospital Carlos III, Madrid, Spain Professor Vincent Soriano Five Nations Conference on HIV and Hepatitis in partnership with COMPETING INTEREST OF FINANCIAL VALUE > £1,000 Statement None Date: December 2015 Hospital Carlos III, Madrid, Spain Professor Vincent Soriano
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in partnership
with
Hospital Carlos III, Madrid, Spain
Professor Vincent Soriano
Five Nations Conference on
HIV and Hepatitis
in partnership
with
COMPETING INTEREST OF FINANCIAL VALUE > £1,000
Statement
None
Date: December 2015
Hospital Carlos III, Madrid, Spain
Professor Vincent Soriano
What’s new in
HIV & HBV Co-Infection ?
Vicente Soriano
Infectious Diseases Unit
La Paz University Hospital & IdiPAZ,
Madrid, Spain
HIV/HBV Outline
� Epidemiology & natural history re-visited
� Treatment issues
� Flares, acute-on-chronic, co-infections
Hepatitis B in 2014
� 240 million chronic carriers worldwide (WHO)
� Hyper-endemic areas in Southeast Asia and Sub-Saharan
Africa
� Oral nucleos(t)ide therapy is effective in most pts, but viral
eradication is not feasible.
� When tenofovir is not available, prevention and
management of LAM resistance requires expertise.
� Given the long asymptomatic period, late diagnosis is
common.
� Despite effective vaccine for 30 years, there is continuous
flow of incident cases (immigrants, non-responders, etc)
� Favorable outcome following liver transplantation
HBV genotypes (8)
Genotype Region Comments
A Northern America More sensitive to IFN
Northern Europe ↑ALT more frequently
India, Africa More rapid 3TC resistance
B Asia More benign
More sensitive to IFN
C Asia More HCC; more resistance
D Southern Europe Less response to IFN
Middle East, India
E West & South Africa
F Central & South America
G USA and Europe
H Central America, California
Kramvis et al. J Viral Hepat 2005; 12: 456-64.
Schaefer et al. Hepatol Res 2007; 37 (suppl): 20-6.