Role Of Hiv Disease In The Pathogenesis Of Hepatitis B

由于抗逆转录病毒治疗，与艾滋病毒有关的机会性感染已显著减少。然而，其他严重的医学疾病，如晚期肝病，已成为艾滋病毒感染者临床护理的一个重要关注领域。在这方面，HIV感染被认为对慢性乙型肝炎病毒（HBV）感染导致的肝脏疾病的进展有负面影响。不幸的是，许多HBV患者使用拉米夫定在一线治疗失败。阿德福韦酯可能为拉米夫定治疗失败的HIV合并HBV感染者提供一种治疗选择。LIR研究人员最近开展了两项临床试验，评估低剂量阿德福韦（每日10mg）治疗慢性乙型肝炎患者的安全性和有效性，这些患者尽管接受了拉米夫定治疗，但仍存在HBV相关肝病和持续性HBV血浆病毒血症。除了评估阿德福韦的临床安全性和有效性外，我们正在研究HIV感染对hbv特异性细胞免疫功能的影响。这些研究将扩大我们对hiv感染者HBV疾病的发病机制和治疗的理解。

HIV related opportunistic infections have declined significantly as a result of anti-retroviral therapy. However, other serious medical diseases, such as advanced liver disease, have become an important area of concern in the clinical care of HIV-infected individuals. In this regard, HIV infection is thought to have a negative impact on the progression of liver disease as a result of chronic hepatitis B virus (HBV) infection. Unfortunately, many individuals with HBV disease fail first-line therapy with lamivudine. Adefovir dipivoxil may offer a therapeutic option to HIV- infected individuals who are co-infected with HBV who have failed lamivudine therapy. LIR investigators have recently opened two clinical trials assessing the safety and efficacy of low-dose adefovir (10 mg daily) for the treatment of chronic hepatitis B in HIV-infected individuals who have HBV-related liver disease and persistent HBV plasma viremia despite lamivudine therapy. In addition to evaluating the clinical safety and efficacy of adefovir, we are investigating the impact of HIV infection on HBV-specific cellular immune function. These studies will expand our understanding of the pathogenesis and treatment of HBV disease in HIV-infected people.