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HBV recurrance/HIV long term
Dec 23, 2002

I am a 43 y/o male who was infected with HIV early 80's and tested positive 17 years ago. What triggered the test was a suppressed CD4 count which led to the discovery of an active HBV infection. This was subsequently followed and the HBV resolved, with a neg surface antigen & core antigen test. My liver function returned to normal for many years. Recently, after 4 years of treatment HAART (Sustiva, Zerit, Epivir) my liver enzymes elevated, and my physician ran a HBV test and a HCV test. HCV came back negative, but the HBV test was positive (expected) but also positive for core & surface antigen.

What could you recommend for treatment to re-resolve the HBV issue? I thought it was unusual for it to recur, once resolved. Need help on this one, as I am doing well otherwise.

Response from Dr. Dieterich

It is possible for HBV to recur in HIV however if you are on zerit, you should also ask your MD to check a serum lactate for liver toxicity from mitochondrial toxicity. You also need to check your e antigen and e antibody and HBV DNA by PCR. If the DNA is elevated, then you should add or substitute Tenofovir (Viread) probably for the zerit. DTD

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