HBV Co-infection (2004)

BHIVA Hepatitis co-infection updated guidelines
October 2004

There are many minor changes in these 2004 guidelines. The main changes include:

HBV

• Reformatted in the style of the ART guidelines.
• Treatment algorithms added.
• New, clearer definitions of when to treat and with what.
  • High CD4: ideally treat according to liver biopsy result. Options are to use interferon if HBeAg +ve (non-cirrhotic) and abnormal LFT or adefovir in those who are HBeAg +ve or HBeAg –ve and HBV-DNA >104 copies/ml (>10³ if cirrhosis)
  • Low CD4 requiring ART : treat according to HBeAg status and HBV-DNA (as above). Can use tenofovir alone as part of HAART. 3TC/FTC are only recommended in combination with tenofovir.
• Updated clinical trial evidence and references.
• New information on investigations and vaccination.

Written on behalf of the British HIV Association.

Principle authors:

• Dr Gary Brook Central Middlesex Hospital, London
• Dr Richard Gilson, Mortimer Market Centre, London
• Dr Ed Wilkins, North Manchester Hospital.

Guideline Committee

• Dr Gary Brook
• Dr Janice Main (Co-Chairs)
• Mr Paul Bateman
• Dr Richard Gilson
• Dr Gayle Mathews
• Dr Mark Nelson
• Prof. Caroline Sabin
• Dr Ed Wilkins.

Brook MG, Gilson R, Wilkins E; BHIVA Hepatitis Coinfection Guidelines Committee. British HIV Association guidelines on HIV and chronic hepatitis: coinfection with HIV and hepatitis B virus infection (2005). HIV Med, 2005, 6 (Suppl 2), 84–95.