Viral hepatitis in practice - 2009


The fight against HIV and hepatitis B co-infection in Africa and Asia
Catherine H Roberts, Anna-Maria Geretti, Geoffrey Dusheiko and Sanjay Bhagani
pp 1-3
The use of combination antiretroviral therapy in resource-rich countries has resulted in a decline in mortality in the HIV-positive population. Despite this, mortality rates have remained greater than among the HIV-negative population. In recent years, several studies in resource-rich countries have assessed causes of death in HIV-infected patients, identifying liver disease as the most frequent non- AIDS cause of mortality, accounting for 12–15% of deaths. While hepatitis C was present in 66.1% of liver-related deaths, active hepatitis B virus (HBV) was found in 16.9% of liver-related deaths.
An instance of hepatic steatosis in association with hepatitis B infection
Phaedra Tachtatzis, Rebecca Brais and Graeme Alexander
pp 4-5
A 42-year old Chinese-American male was referred to the hepatology clinic because he was positive for hepatitis B virus surface antigen, with abnormal liver function tests.
Comment: Challenges that need to be met
Geoffrey Dusheiko
pp 5-5
In this issue of Viral hepatitis in practice, two challenging populations requiring treatment are discussed. Roberts at al discuss hepatitis B (hep B) co-infection in Africa and Asia (see page 1). A higher prevalence of active hep B is frequently found in HIV-positive individuals. The reasons for this are multifactorial, but, in part at least, the shared prevalence is related to similar modes of transmission in many areas of the world – particularly in individuals who acquire the diseases as adults. The picture may be more complex where hep B is acquired in childhood, as previously hep B-infected children may later acquire HIV via sexual transmission.
NICE guidance on hepatitis B treatments
Gary Brook
pp 6-8
Over the last three years, the National Institute for Health and Clinical Excellence (NICE) has produced guidance on five different treatments for chronic hepatitis B virus (HBV) infection. Based on cost-effectiveness, peginterferon alfa-2a, adefovir, and entecavir are recommended treatments.
The potential for treatment of chronic hepatitis C in injecting drug users
Brian J Thomson
pp 9-11
Hepatitis C virus is a major cause of morbidity and mortality worldwide. Chronic HCV infection carries a significant risk of life-threatening complications of cirrhosis of the liver, end-stage liver disease and hepatocellular carcinoma, and is the most common reason for liver transplantation in industrialised countries. Up to 500,000 individuals in the UK are estimated to have been infected with HCV.

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