Virological and clinical aspects of HBV‐HCV coinfection in HIV positive patients

In a long‐term follow‐up study the clinical and virological presentation of HBV/HCV coinfection in anti‐HIV positive patients was evaluated. Plasma HBV‐DNA, HCV‐RNA, and HIV‐RNA were determined by PCR in 5 HBsAg/anti‐HCV/anti‐HIV positive patients, in 4 HBsAg/anti‐HIV positive patients and in 82 anti‐HCV/anti‐HIV positive patients first observed at a Unit of Infectious Diseases in Naples (Italy) from 1990 to 2000 (follow up 6–16 years). All five hepatitis B and C coinfected patients showed reciprocal inhibition of viral replication on admission and during the follow up. At the end of the follow up a clearance of HBsAg from serum was observed in four patients and a clearance of anti‐HCV in one of them. In two patients after clearance of HBsAg, evidence of occult HBV infection was observed, at times associated with a hepatic flare. None of the four patients with HIV/HBV coinfection lost HBsAg and none of the 82 with HIV/HCV coinfection lost anti‐HCV during the follow up. In anti‐HIV positive patients HBV/HCV coinfection is characterized by reciprocal inhibition of viral replication, more evident in HBV expression in plasma and at times by progression to occult HBV infection. J. Med. Virol. 79:1679–1685, 2007. © 2007 Wiley‐Liss, Inc.