Depending on the type of hepatitis different aspects concerning the coinfection with hepatitis and HIV are relevant.
For instance, a coinfection with HBV is normally treated simultaneously with antiretroviral therapy, as some drugs used in HIV therapy (in particular tenofovir either as TDF or TAF) are also active against the hepatitis B virus.
However, it is important to consider hepatitis B if changes in HIV therapy are made. Discontinuing HIV drugs which are also effective against hepatitis B without adequate replacement can cause a flare of the hepatitis B infection and a worsening of the liver disease.
HCV/HIV coinfection is treated separately with antivirals with specific actions against HCV. Treatment duration is finite usually lasting 8-12 weeks.
Today, HBV infection is easier to deal with than in the past, as some antiretroviral drug also effectively inhibit the replication of HBV. These drugs are
As a result HBV infection can usually be controlled very well, in particular when using tenofovir, which should be the preferred therapy.
Treatment of hepatitis C with interferon free all oral medications is today as effective in HIV-coinfected as in HCV-monoinfected patients usually achieving viral cure in >95% of treated patients (see Hepatitis | Diagnosis & treatment).
Cohort studies in HIV /HCV coinfected patients show a more favourable course of liver disease in patients receiving antiretroviral therapy. Antiretrovirally treated patients suffer less from severe complications of their liver disease than coinfected patients without antiretroviral treatment. Most of the effect may be due to the improvement of the immune system after the control of HIV.