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Liver Disease The Leading Cause of Death in HIV: Hepatitis screening campaign launched. AASLD Liver Conference Starts Nov 10 in SF
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Bay Area Reporter
By Alexandra L.Woodruff
Nov 10, 2005
Liver disease is now the leading cause of death for people living with HIV, said Dr. Teresa Wright, the president of the American Association for the Study of Liver Diseases.
The AASLD and the American Liver Foundation have declared November "Hepatitis Screening Month" in San Francisco to help raise awareness about liver diseases.
Improved treatments are allowing HIV patients to live longer, but they are still at risk for other diseases like hepatitis B and C.
"These other medical issues, that used to be less important because people would die of the HIV first, are now emerging as leading causes of death," said Wright, who is also a professor of medicine at the University of California, San Francisco.
The AASLD is holding its annual conference in San Francisco this month to talk about the latest advances in hepatitis treatment. The meeting is for medical doctors, but the organization is launching a public awareness campaign to go along with the conference.
"Hepatitis B and hepatitis C are often silent infections that can cause significant damage to your liver," Wright said.
Hepatitis many times doesn't show symptoms, so people infected can unknowingly transmit it through unprotected sex and intravenous drug use. High-risk behaviors make the gay population more at risk for hepatitis B, Wright said.
Vaccines can prevent hepatitis A and B. There isn't a vaccine for hepatitis C, which is mostly spread through intravenous drug use. Hepatitis B is usually transmitted sexually.
"The risk factors for HIV are exactly the same as the risk factors for hepatitis B," Wright said.
The organizers want to let people know there are new ways to deal with both of the viruses that attack the liver. Adrian Di Bisceglie, the organization's public policy committee chair, said it's important that people are tested for the disease.
"If we don't know they have it, we can't treat them," said Di Bisceglie, a professor of internal medicine at St. Louis University.
For many years, modern medicine couldn't do much for a hepatitis B or C diagnosis, said Di Bisceglie.
"In the last 10 years, we've really turned that around dramatically and we have very good treatments for a lot of liver diseases," he said.
Many of the advances are in new drug developments. Researchers will present five drugs still being tested at the symposium. Treatments for HIV patients have to be tailored to an individual's diagnosis.
Wright recommends doctors treating patients with both HIV and hepatitis should treat the hepatitis virus even when there aren't signs of liver damage. HIV speeds up the progression of hepatitis C and probably, hepatitis B, she said.
"It emerges as a more rapid problem in people who have HIV," Wright said.
Doctors treating hepatitis B and C in HIV patients are different and doctors need to know how to assess the different viruses, Wright said.
Treatments can be tricky for those with both hepatitis B and HIV. Certain antiviral drugs used to keep the HIV virus in check can ultimately be counterproductive in patients with hepatitis B. If medical doctors don't add another drug to the mix, the drug treating AIDS could become ineffective.
“They (physicians0 can inadvertentlyand by mistake, generate resistance to hepatitis B through giving the medication for the HIV medication”, Wright said. Wright is referring here to using 3TC (lamivudine) in a HAART regimen without tenofovir or another HBV drug).
The drugs used for hepatitis C don't have the same problem. The best thing hepatitis C patients can do is to keep the HIV virus under control, Wright said.
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