Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virology. May 12, 2015; 4(2): 96-104
Published online May 12, 2015. doi: 10.5501/wjv.v4.i2.96
Viral hepatitis and human immunodeficiency virus co-infections in Asia
Takako Utsumi, Maria I Lusida
Takako Utsumi, Maria I Lusida, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya 60115, Indonesia
Takako Utsumi, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
Maria I Lusida, Faculty of Medicine, Airlangga University, Surabaya 60131, Indonesia
Author contributions: Both authors made a substantial contribution to the conception and design of the study, data acquisition and to drafting and critically revising the manuscript. Both authors approved the final version.
Supported by The Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) program from the Ministry of Education, Culture, Sports, Science and Technology, Japan.
Conflict-of-interest: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takako Utsumi, PhD, Center for Infectious Diseases, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. tutsumi@people.kobe-u.ac.jp
Telephone: +62-31-5992445 Fax: +62-31-5992445
Received: October 30, 2014
Peer-review started: November 2, 2014
First decision: December 2, 2014
Revised: January 5, 2015
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: May 12, 2015
Abstract

Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) affect many people in Asian countries, although there are geographic differences. Both HBV and HIV (HBV/HIV) and HCV/HIV co-infections are highly prevalent in Asia. Hetero- and homosexual, injection drug use, and geographic area are strong predictors of HBV, HCV, and HIV serostatus. In HBV endemic regions, the prevalence and genotype distribution of HBV/HIV co-infection is almost comparable with that in the general population. In Japan, where HBV has low endemicity, the prevalence of HBV/HIV co-infection is approximately 10-fold higher than that in the general population, and HBV Ae is the most common subgenotype among HIV infected individuals. Highly active antiretroviral therapy (HAART) is an effective treatment for HIV/Acquired Immune Deficiency Syndrome. Lamivudine, a component of HAART, is an effective treatment for HBV, HIV, and HBV/HIV co-infection; however, cost, emerging drug resistance, antiretroviral-associated liver toxicity and liver-related morbidity due to HCV progression are particular concerns. HCV/HIV co-infection may accelerate the clinical progression of both HCV and HIV. The high prevalence of HBV/HIV and HCV/HIV co-infections in Asia underscores the need to improve prevention and control measures, as fewer evidence-based prevention strategies are available (compared with Western countries). In this review, the most recent publications on the prevalence of HBV/HIV and HCV/HIV co-infections and related issues, such as therapy and problems in Asia, are updated and summarized.

Keywords: Hepatitis B virus, Hepatitis C virus, Co-infection, Human immunodeficiency virus, Prevalence, Asia, Pathogenicity, Natural history, Problems, Drug resistance

Core tip: Hepatitis B virus (HBV) and hepatitis C virus (HCV), infections are common among human immunodeficiency virus (HIV) positive individuals due to similar blood-borne transmission routes. Highly active antiretroviral therapy is an effective treatment for HIV/acquired immune deficiency syndrome; however, emerging drug-resistant viruses and drug-induced hepatotoxicity are particular concerns. The high prevalence of HBV/HIV and HCV/HIV co-infections in Asia highlights the need to improve prevention and control measures because, unlike in Western countries, few evidence-based prevention strategies are available. Here, we review the epidemiologically and clinically important aspects of HBV/HIV and HCV/HIV co-infections in Asian countries.