High rates of hepatitis B virus (HBV) functional cure among HIV/HBV coinfected Chinese adults on antiretroviral therapy.
High rates of hepatitis B virus (HBV) functional cure among HIV/HBV coinfected Chinese adults on antiretroviral therapy.
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DOI：
10.1097/cm9.0000000000002501
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发表时间：
2022-11-20
影响因子：
6.1
通讯作者：
中科院分区：
文献类型：
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报告显示，全世界约有3770万人感染了人类免疫缺陷病毒（HIV），[1] 10%至28%的HIV感染者（PLWH）合并感染了B型肝炎病毒（HBV）。[2]HIV和HBV共有的传播途径可以解释HIV/HBV合并感染的相对高比例，[3]这对全球公共卫生构成了重大挑战。在中国，B型肝炎表面抗原（HBsAg）在PLWH中的患病率估计为13.7%。[4]与HBV单一感染者相比，合并感染HIV的人可能会经历更快的肝病进展，并增加发展晚期肝病的风险，如肝硬化或肝细胞癌（HCC）。[5]尽管对HBV和HIV都具有抗病毒活性的强效抗逆转录病毒治疗方案被广泛使用，但肝脏相关死亡率仍然是合并感染个体的第二大常见死亡原因。[6]此外，尽管抗逆转录病毒治疗（ART）的早期引入，高HBV复制谱的HIV/HBV合并感染者继续有较高的死亡风险。[7]HBsAg清除/丢失伴或不伴B型肝炎表面抗体（抗-HBs）形成被认为是HBV单一感染的“功能性治愈”。[8]功能性治疗可降低肝病进展和HCC发展的风险。[8，9]简而言之，这是HIV/HBV合并感染个体的最终治疗目标。
Reports suggest that approximately 37.7 million people are infected with human immunodeficiency virus (HIV) worldwide,[1] and 10% to 28% of people living with HIV (PLWH) are coinfected with hepatitis B virus (HBV).[2] The routes of transmission shared by both HIV and HBV may explain the relatively high proportions of HIV/HBV coinfection,[3] which represent a significant challenge to global public health. In China, hepatitis B surface antigen (HBsAg) prevalence is estimated at 13.7% in PLWH.[4]Compared to HBV mono-infected individuals, those coinfected with HIV may experience a faster progression of liver disease and an increased risk of developing advanced liver diseases such as cirrhosis or hepatocellular carcinoma (HCC).[5] Despite the widespread utilization of potent antiretroviral regimens with antiviral activities against both HBV and HIV, liver-related mortality remains the second most common cause of death among coinfected individuals.[6] In addition, despite the early introduction of antiretroviral therapy (ART), HIV/HBV coinfected individuals with high HBV replication profiles continue to have a higher mortality risk.[7] HBsAg clearance/loss with or without development of hepatitis B surface antibody (anti-HBs) is regarded as a “functional cure” for HBV mono-infection.[8] Functional cure decreases the risk of liver disease progression and development of HCC.[8, 9] In short, this is the ultimate treatment target for HIV/HBV coinfected individuals.