affects millions of people worldwide. Most acute cases resolve in several months, but about 5 percent of adults and many children who contract the disease go on to develop a chronic form of Hepatitis B. That can cause long term liver damage, such as cirrhosis and liver cancer. About a quarter of the people with chronic hepatitis B will die if they don't get treatment.
Now there's word that a common drug used to treat Hepatitis B could cause problems in patients who also are infected with HIV. Dr. Chloe Thio from the Johns Hopkins University in Baltimore noticed an interaction in patients who suffered from both diseases and were taking the drug entecavir to treat the hepatitis.
“What we noticed is that their HIV viral load, or the amount of virus, HIV virus in their body decreased by about tenfold when entecavir was initiated.”
At first glance that would seem to be a good thing - doctors want to reduce the amount of virus in the blood of HIV patients. But Thio says the story is not that simple.
“We know, historically, when we treated HIV a long time ago with one drug, that treating HIV with one drug is not a good thing, because the virus can mutate or change itself so that the drugs don't work anymore. So then we went on to investigate, 'well, is this happening with this drug in these people?”
And, in fact, Thio says, the HIV viruses in her patients did develop mutations, and over time, those mutations prevented HIV drugs from working.
“Part of the problem may even be in other countries where Hepatitis B is endemic, is that people may be using it to treat hepatitis B and not even know that someone is HIV infected. So someone might think this person is only Hepatitis B, I'm going to treat them with entecavir, because it's a very potent drug. But if they have HIV at the same time and it's not tested for, then that could be dangerous.”
Thio estimates about there are about 4 million people worldwide co-infected with Hepatitis B and HIV. She says people wanting to use entecavir should be sure they are not HIV-positive.
Thio presented her research at the annual Conference on Retroviruses and Opportunistic Infections, held in Los Angeles this month.