Audit finds varied HBV monitoring after switching HIV patients to HBV-inactive ART

An audit of people with HIV who showed serological evidence of hepatitis B virus exposure has found that a small number were switched to antiretroviral therapy regimens that lack hepatitis B active agents, and that clinical monitoring practices around these switches varied considerably.

The audit, published in AIDS Research and Therapy as a Brief Communication, examined 183 patients with current or prior HBV exposure. Of these, 12 patients were switched to HBV-inactive antiretroviral therapy, meaning regimens that do not include drugs with activity against hepatitis B.

According to the authors, there were significant variations in the testing practice performed before and after the switch to monitor potential HBV activity. This suggests that clinicians managing these patients did not follow a uniform approach to checking whether hepatitis B remained suppressed once HBV-active drugs were removed from the regimen.

The authors note that consistency between guidelines would enhance implementation efforts in their context. The finding highlights a practical question raised by the study: how HBV-inactive antiretroviral therapy affects clinical monitoring in patients co-infected with HIV and HBV, and what optimal monitoring practices should be for HBV exposure in HIV patients on antiretroviral therapy.

As an audit of clinical practice rather than an intervention study, the work describes what was observed at a single service setting and does not establish outcomes of any particular monitoring approach. The authors frame their conclusion around the need for greater guideline consistency to support implementation in their context.

Subject of Research: Clinical monitoring of HIV patients with hepatitis B exposure switched to antiretroviral therapy lacking hepatitis B active agents

Article Title: Clinical monitoring for people with HIV and serological evidence of HBV exposure in the era of anti-retroviral therapy without hepatitis B active agents

Article References: Hinh, J., Hung, K., Woolley, I., & Krishnaswamy, S. (2026). Clinical monitoring for people with HIV and serological evidence of HBV exposure in the era of anti-retroviral therapy without hepatitis B active agents. AIDS Research and Therapy. https://doi.org/10.1186/s12981-026-00950-w

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DOI: 10.1186/s12981-026-00950-w

Keywords: HIV, hepatitis B virus, antiretroviral therapy, HBV-inactive ART, clinical monitoring, clinical audit, co-infection, guidelines, AIDS Research and Therapy, serological exposure, Clinical, monitoring