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HIV Treatment Bulletin

Updated UK guidelines for HIV and hepatitis coinfection (2005)

Updated guidelines are now available on the British HIV Association BHIVA website.

www.bhiva.org

The major changes for each section include:

HBV coinfection

  • Reformatted in the style of the ART guidelines.
  • Treatment algorithms added.
  • New, clearer definitions of when to treat and with what.
  • High CD4: ideally treat according to liver biopsy result. Options are to use interferon if HBeAg +ve (non-cirrhotic) and abnormal LFT or adefovir in those who are HBeAg +ve or HBeAg –ve and HBV-DNA >104 copies/ml (>103 if cirrhosis)
  • Low CD4 requiring ART: treat according to HBeAg status and HBV-DNA (as above). Can use tenofovir alone as part of HAART. 3TC/FTC are only recommended in combination with tenofovir.
  • Updated clinical trial evidence and references.
  • New information on investigations and vaccination.

HCV coinfection

  • Reformatted in the style of the ART guidelines.
  • Recommended treatment is with pegylated interferon and ribavirin
  • Non-pegylated interferon is no longer recommended
  • Updated information on clinical trails and references
  • Deletion of discussion on non-pegylated interfero
  • Recommend avoid AZT and ddI in those on ribavirin.