HIV-HBV-Koinfektion - Diagnostik und Therapie

Zusammenfassung

Durch die stetige Abnahme der Mortalität und Morbidität der HIV-Infektion fokussieren sich heute die Probleme nicht mehr allein auf AIDS-spezifische Erkrankungen, sondern auch auf andere Ursachen wie virale Koinfektionen. Aufgrund sich überlagernder Transmissionswege von HIV und Hepatitis B sieht man Koinfektionen hier häufig. Patienten, die eine HIV-HBV-Koinfektion aufweisen, zeigen insgesamt einen ungünstigeren Verlauf der Hepatitis B-Infektion als Monoinfizierte. Komplexe immunologische Veränderungen unter einer HIV-Infektion führen zudem oftmals zu einem eher atypischen Verlauf der Hepatitis-B Infektion.

Wenn eine Therapieindikation der Hepatitis B vorliegt, sollte die Therapieindikation für die HIV-Infektion geprüft werden. Liegt hierfür keine Indikation vor, sollten HIV-wirksame Medikamente nicht eingesetzt werden, um Resistenzbildungen seitens des HI-Virus zu vermeiden. Besteht eine Indikation zur Behandlung beider Infektionen sollte eine antivirale Kombinationstherapie mit HBV-wirksamen Substanzen eingeleitet werden.

Summary

Owing to the steady decrease in mortality and morbidity of HIV-infection, current problems have not solely focussed on HIV-specific diseases, but also on other causes such as coinfections. Due to overlapping modes of transmission between HIV and HBV such coinfections have been frequently observed. Patients suffering from coinfections display overall a more unfavourable outcome compared to monoinfected patients. Complex immunologic changes during a HIV-infection often lead to an atypical course of HBV-infection.

Given the indication for treatment of HBV, the treatment indication for HIV should be considered. If such an indication has not been ruled out, HIV-directed medications should not be admistered in order to avoid the formation of resistant HIV strains. If an indication for treatment of both viruses has been demonstrated, an antiviral combination therapy should be initiated.

Schlüsselwörter

HIV-Infektion - Hepatitis B - HAART

Key words

HIV-infection - hepatitis B - HAART

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