Adapted from: Chen DS, et al. J Gastroenterol Hepatol 1993;8:470–5; Seeff L, et al. N Engl J Med 1987;316:965–70; Thio CL, et al. Lancet 2002;360:1921–6; Gilson RJ, et al. AIDS 1997;11:597–606; Colin JF, et al. Hepatology 1999;29:1306–10.
Natural history of HBV infection
– where does co-infection fit in?
HIV/HBV
Higher
viral loads
HIV/HBV:
Increased viral loads
Lower ALT
Increased fibrosis
HIV/HBV
Reduced seroconversion
HIV/HBV
Increased likelihood
Inactive carrier
< 5%
Immune tolerance
> 95%
HBeAg–
Chronic
Hepatitis B
HBeAg+
Chronic
Hepatitis B
Early childhood
Adulthood
HCC
HBeAg, hepatitis B e antigen; HCC, hepatocellular carcinoma.

This slide highlights the risk of cancer. A patient can progress to cancer from any of the 4 highlighted states.