Management of hepatitis B and HIV coinfection

2012 HIV/AIDS treatment and care. Clinical protocols fo

Histological evaluation. [...] Non-invasive methods for measuring fibrosis such as serum markers of fibrosis or hepatic elastography (FibroScan) correlate well with cirrhosis and a fibrosis score <F2. If these methods are available, they may in such cases substitute for performing a liver biopsy. For F2 and F3 the correlation between non-invasive methods and liver biopsy is weaker, and patients with scores in this intermediate range may be considered for liver biopsy if this affects decision-making. [...] Liver stiffness cut-offs for the thresholds of significant fibrosis and cirrhosis, as assessed by hepatic elastography, may be different to cut-offs used for chronic HCV. [...]
Use of FibroScan and serum fibrosis markers are also proposed in an algorithm for the evaluation and treatment of patients with chronic hepatitis B and HIV co-infection in the absence of clinical cirrhosis.