Research on HIV Co-Infections

HIV-infected people are at increased risk of diseases caused by infection with infectious agents such as Mycobacterium tuberculosis and other mycobacteria, hepatitis C, hepatitis, B,Pneumocystis carinii, cryptococci, fungi, and human cytomegalovirus. While diseases caused by many of these pathogens are less common today in HIV infected patients receiving HAART, co-infection with tuberculosis (TB), hepatitis C virus (HCV), and hepatitis B (HBV) remain significant causes of illness and death among people living with HIV, especially in regions where the risk of co-infection is high.

Among persons infected with HIV, TB is the leading cause of death and can accelerate the progress of HIV infection. HIV infection is associated with increased susceptibility to TB and worse TB treatment outcomes because of weakened immune defenses and drug-drug interactions complicating co-treatment of HIV and TB.
As a result of prolonged survival, greater numbers of HIV-infected people are exhibiting the long-term complications of HCV infection, namely end-stage liver disease and hepatocellular carcinoma. Infection by HCV, in some instances, has been shown to interfere with HAART regimens.
HBV-HIV co-infection is associated with increased rates of morbidity and mortality above those caused by either infection alone. Treating hepatitis B in HIV patients is complicated by the dual activity of some nucleoside analogues and emergence of HIV or HBV resistance.

NIAID current research activities include the following:

Development of drugs and drug regimens (including novel formulations) to improve the treatment of HIV associated co-infections
Studies of the pathogenic interactions of HIV and associated coinfections.
Development of vaccines for TB infection and disease
Discovery and development of biomarkers to improve diagnosis and treatment of HIV associated co-infection