Initiating Treatment in Patients with Hepatitis B and HIV Coinfection

You answered:

D Peginterferon alfa would be considered first-line therapy for this patient's HBV infection given his HBeAg positive status.

This answer is incorrect. Peginterferon alfa is not considered first-line treatment in HBV-HIV coinfected patients given limited data on efficacy. Moreover, HBeAg status is only one of a number of considerations when weighing the option of peginterferon for HBV.

Choose another answer:

A The patient should undergo a liver biopsy to determine if the HBV should be treated along with treatment for HIV infection.
B The patient should be started on a highly active antiretroviral therapy regimen that also will effectively treat hepatitis B.
C Antiretroviral therapy for HIV is indicated, but antiviral therapy for HBV is not indicated because of the normal ALT. The antiretroviral combination should exclude tenofovir, emtricitabine, and lamivudine, since each of these antiretroviral medications also has activity against HBV.

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