Routine hepatitis B virus DNA testing in patients with human immunodeficiency virus


  • Potential conflict of interest: Nothing to report.

Routine Hepatitis B Virus DNA Testing in Patients with Human Immunodeficiency Virus

To the Editor:

We read the article by Núñez with great interest.1 In the literature, three cases who were positive for human immunodeficiency virus (HIV) were described with hepatitis B reactivation after withdrawal of hepatitis B virus (HBV)-active drug due to the virologic failure of HIV. All three of the patients were positive for antibody to hepatitis B core antigen (anti-HBc).2, 3 The HBV reactivations could be controlled by highly active antiretroviral therapy regimens including lamivudine and tenofovir in the first patient,2 tenofovir/emtricitabine in the second patient,3 and without any HBV-active drug in the third patient.2

The author's concerns were mostly based on economics. However, without knowing the HBV DNA presence, we should get some different recommendations for clinicians, such as choosing an HBV-active drug in all anti-HBc–positive patients with HIV. Moreover, some authors also suggest hat the follow-up should be based on HBV DNA levels in only anti-HBc–positive patients with HIV.2

Akif Altinbas M.D.*, Fuat Ekiz M.D.*, Osman Yuksel M.D. Assoc. Prof*, * Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Education and Research Hospital Ankara, Turkey.