Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection accelerates liver disease progression and increases the risk of hepatocellular carcinoma (HCC). Lifelong HBV-active antiretroviral therapy is the cornerstone of management, while occult HBV infection and isolated anti-HBc serology require careful monitoring, particularly when switching to long-acting regimens lacking HBV activity. Comprehensive diagnostics, including HBV DNA testing, fibrosis assessment, and evaluation of serological profiles, are essential for optimal care. Vaccination with next-generation HBV vaccines (ex. CpG adjuvant, multiantigenic), provides superior immunogenicity and should be prioritized in people living with HIV, especially in prior nonresponders. Regular HCC screening is recommended in individuals with advanced liver disease to enable early detection and intervention. This review summarizes current evidence on diagnostics, therapy, vaccination, monitoring, and cancer prevention, providing practical recommendations to improve outcomes in HIV/HBV coinfected populations.
The objective of this review was to summarize previous Polish experience in treating hepatitis C virus (HCV) in children with direct-acting antivirals (DAAs) and to describe the current situation and perspectives for future HCV treatment in the pediatric cohort. Children aged at least 3 years were only included in the national Polish therapeutic HCV program on April 1, 2025. However, since 2018, over 200 children and adolescents have been treated with DAAs in noncommercial and commercial trials and real-life programs. Through the current therapeutic program, only adult dosages and formulations of DAAs are available; thus, younger children may not be included. They may, however, receive pediatric formulations donated courtesy of pharmaceutical companies. Screening programs, at least for children at risk of HCV infection, should be implemented to identify candidates for DAA treatment.
The Polish Group of Experts (PGE) for hepatitis B virus (HBV), established by the Polish Society of Epidemiologists and Infectious Disease Physicians and the Polish Association for the Study of the Liver, published its first HBV management recommendations in 2007. The current recommendations have been expanded to include the prevention of HBV infection in various populations, the prevention of HBV reactivation, principles for monitoring treatment efficacy and safety, including early detection of hepatocellular carcinoma, and principles for safe treatment discontinuation and interruption. Recommendations for management of acute hepatitis B and co-infections with HDV, HCV, and HIV are also included. Consensus among the ten PGE HBV members was achieved using the Delphi method (5 survey rounds resolving 36 key issues; 2 discussion rounds to clarify doubts).
Chronic liver diseases (CLDs) represent a growing global health challenge, driven by the increasing prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), its progressive inflammatory-fibrotic form (metabolic dysfunction-associated steatohepatitis - MASH), as well as viral infections, alcoholic liver disease, and autoimmune and cholestatic disorders. Despite intensive research, effective pharmacological therapies capable of halting or reversing fibrosis progression - particularly in MASH - remain lacking. In recent years, incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and a new generation of metabolic multi-agonists, have gained breakthrough significance. These agents demonstrate potent metabolic, anti-inflammatory, and anti-steatotic effects, as well as potential antifibrotic activity, making them promising candidates for the treatment of various CLD phenotypes, including MASLD/MASH-associated fibrosis. This review synthesizes current knowledge on the mechanisms of action of these drugs, clinical trial outcomes, and their potential application as novel, targeted therapies in CLDs.
