This protocol addresses people living with HIV/AIDS who also have chronic hepatitis B virus (HBV) infection, confirmed by a positive hepatitis B surface antigen (HBsAg) test. Because both viruses are active simultaneously, the antiretroviral strategy must account for this coinfection from the outset.
Chronic Hepatitis B — HBsAg-PositiveApproximately 5% to 15% of people with HIV in the United States also have chronic hepatitis B virus (HBV) infection. Choosing an antiretroviral regimen without accounting for concurrent HBV activity risks inadequate control of both infections and potential liver disease progression.
In this coinfection setting, the antiretroviral regimen is built around an NRTI backbone selected specifically for dual activity against both HIV and HBV. An alternative strategy is available for patients in whom the preferred backbone agents cannot be used. The full regimen structure, sequencing, and individual agent selection are detailed in the complete protocol.
Approximately 5% to 15% of people with HIV in the United States also have chronic hepatitis B virus (HBV) infection, defined as positive HBV surface antigen (HBsAg).
Because tenofovir alafenamide (TAF), tenofovir disoproxil fumarate (TDF), emtricitabine (FTC), and lamivudine (3TC) are active against both HIV and HBV, an antiretroviral (ARV) regimen for people with both HIV and HBV should include (TAF or TDF) plus (3TC or FTC) as the nucleoside reverse transcriptase inhibitor (NRTI) backbone of a fully suppressive ARV regimen (AI).
If TAF or TDF cannot be safely used, or if there is a desire to use a tenofovir-sparing ART regimen, entecavir should be used as the alternative HBV therapy (BI).
View source ↗