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Hepatitis B + HIV Co-infection

If you are living with HIV and have recently been diagnosed with hepatitis B, more than 90% of people get over their symptoms and make a full recovery with no lasting damage to their liver. One to ten percent of older children and adults, become chronically infected. [2] If you have chronic hepatitis B and HIV, this information may be helpful.
[2] (NSW Health, Communicable Diseases Factsheet, Hepatitis B, pp1, 2006)

How serious is Hepatitis B and HIV?

It is generally thought that having hepatitis B does not increase HIV disease progression and severity. However because anti-HIV treatments have extended life expectancy and decreased illness, hepatitis B and C have emerged as a significant cause of illness and death in people living with HIV for extended periods of time.

Hepatitis B and HIV co-infection can be a serious health risk, needing careful treatment and management.

HIV treatment and hepatitis B

When some people with HIV and chronic hepatitis B start taking anti-HIV treatment, they may experience a short–term flare up of hepatitis B. This is usually the consequence of the anti-HIV treatment restoring the immune system, which then becomes better at responding to infections such as hepatitis B. This improved immune response can lead to active hepatitis disease.

To try and prevent these flare ups, many doctors recommend that people with chronic hepatitis B - who are starting anti-HIV treatment - should start treatment for hepatitis B infection at the same time.

People with hepatitis B appear to be at greater risk of experiencing increases in liver enzymes which some HIV treatments and other drugs can cause.

Hepatitis B treatment - if you have HIV

Some people may benefit from special anti-viral treatment, however viral infections such as hepatitis B can be difficult to treat. Talk to your doctor. Anti-viral treatment for hepatitis B is improving all the time and new drugs are coming on line.

People with hepatitis B need to take extra care of their liver. Alcohol can make any liver disease worse. You may have to stop drinking and avoid recreational drugs while your liver recovers. You may also need plenty of rest, which can mean taking leave from work.

Many doctors recommend that if a person with hepatitis B is taking anti-HIV treatment, their regime should include an HIV drug that is also effective against hepatitis B: 3TC, FTC, tenofovir or truvada. Talk with your doctor.

Taking care of your liver

It is important to have your liver function carefully and regularly monitored. You may also need to take extra care and avoid other risky activities that can stress or damage your liver:

Protect your liver from further damage by having a hepatitis A vaccination – if you haven’t already had the infection
Stop or cut down alcohol intake
Stop or reduce illicit drug intake
Eat a balanced diet
Learn how to manage stress
Rest when feeling unwell
Talk to someone close about feelings or problems
Some herbal treatments need to be taken with caution as they may harm your liver. Check with your doctor before taking prescription or over-the-counter drugs including complementary (herbal) therapies, and follow the directions carefully.

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