Individuals with chronic hepatitis B virus (HBV) infection who are at substantial risk of HIV acquisition benefit from pre-exposure prophylaxis (PrEP) with tenofovir-based antiviral therapy. Considering that tenofovir potently inhibits HBV, providing PrEP to individuals with HBV effectively results in treatment of their HBV infection. However, some clinicians might be hesitant to initiate PrEP in people with chronic HBV due to unknown risks of HBV reactivation, hepatitis, and acute liver failure during periods of antiviral cessation. Unfortunately, these knowledge gaps affect scale up of PrEP among people with chronic HBV. Emerging data regarding the risks and benefits of antiviral cessation in people with chronic HBV suggest that PrEP can be safely initiated despite the risks of non-adherence or discontinuation. People with chronic HBV who stop PrEP should be closely monitored for HBV reactivation and hepatitis flares after antiviral cessation.

患有慢性乙型肝炎病毒 (HBV) 感染且具有感染 HIV 风险的个体可受益于基于替诺福韦的抗病毒治疗的暴露前预防 (PrEP)。考虑到替诺福韦可有效抑制 HBV，向 HBV 感染者提供 PrEP 可以有效治疗其 HBV 感染。然而，一些临床医生可能会犹豫是否要对慢性乙型肝炎患者启动 PrEP，因为在抗病毒药物停止期间乙型肝炎病毒再激活、肝炎和急性肝功能衰竭的风险未知。不幸的是，这些知识差距影响了慢性乙型肝炎患者中 PrEP 的推广。关于慢性乙型肝炎患者停止抗病毒治疗的风险和益处的新数据表明，尽管存在不依从或停止的风险，但可以安全地开始 PrEP。停止 PrEP 的慢性 HBV 患者应在停止抗病毒治疗后密切监测 HBV 再激活和肝炎发作。