HBV and HIV co-infection:Impact on liver pathobiology and therapeutic approaches

The consequences of hepatitis B virus(HBV) and human immunodeficiency virus(HIV) co-infection on progression of severe liver diseases is a serious public health issue,worldwide. In the co-infection cases,about 90% of HIV-infected population is seropositive for HBV where approximately 5%-40% individuals are chronically infected. In HIV co-infected individuals,liverrelated mortality is estimated over 17 times higher than those with HBV mono-infection. The spectrum of HIVinduced liver diseases includes hepatitis,steatohepatitis,endothelialitis,necrosis,granulomatosis,cirrhosis andcarcinoma. Moreover,HIV co-infection significantly alters the natural history of hepatitis B,and therefore complicates the disease management. Though several studies have demonstrated impact of HIV proteins on hepatocyte biology,only a few data is available on interactions between HBV and HIV proteins. Thus,the clinical spectrum as well as the complexity of the co-infection offers challenging fronts to study the underlying molecular mechanisms,and to design effective therapeutic strategies.