KEY POINTS
- Co-infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) and hepatitis C and D viruses (HCV and HDV) results in worse outcomes for patients in terms of all-cause mortality, liver disease and hepatocellular carcinoma (HCC).
- All individuals with chronic hepatitis B (CHB) should be tested for co-infection following appropriate pre-test discussion.
- People with ongoing risk factors for co-infection should be offered repeat testing, particularly in the setting of clinical deterioration.
- People with HCV co-infection should be offered treatment with direct-acting antiviral (DAA) therapy and the need for HBV treatment reassessed before commencing HCV therapy. If not on antiviral therapy for HBV, additional monitoring during DAA therapy may be required.
- The approach to treatment for patients with co-infection is more complex than in the setting of mono-infection, and can be associated with increased risk of adverse outcomes.
- All patients undergoing significant immune suppression should be tested for HBV infection as viral reactivation and associated flares of hepatitis can occur, which can be fatal.
Click to open GESA recommendations
GESA Consensus Recommendation 25
GESA Consensus Recommendation 26
GESA Consensus Recommendation 27
GESA Consensus Recommendation 28
GESA Consensus Recommendation 29
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