The epidemiology, natural history and prevention of hepatitis B: implications of HIV coinfection.

Approximately 350 million people have chronic hepatitis B infection, a leading cause of cirrhosis and hepatocellular carcinoma (HCC). Patients who are infected through parenteral or sexual transmission are also at risk for acquisition of HIV. Concomitant HIV infection can lead to an increased risk of morbidity and mortality from hepatitis B virus (HBV)-related cirrhosis, end-stage liver disease and HCC. This review will focus on the epidemiology, natural history and prevention of HBV infection and the modulating effect of HIV on the clinical expression of HBV disease.