Chapters authored
Current Therapeutic Options for HCV-HIV Coinfection
Due to shared risk factors for transmission, coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a very common event. The prevalence of HCV infection among HIV-positive patients averages about 35%. In HIV/HCV co-infected patients, liver-related morbidity and mortality is a prominent non-AIDS-defining complication: up to 90% of liver-related deaths in HIV-infected patients are attributable to HCV. The progression of liver fibrosis is accelerated in HIV/HCV-coinfected patients, particularly in individuals with low CD4 counts (≤350 cells/mm3). Antiretroviral therapy may slow liver disease progression in HIV/HCV-coinfected patients and should, therefore, be considered for all coinfected patients regardless of CD4 cell count. Most patients with HIV/HCV coinfection are taking multi-drug antiretroviral therapy, which may pose a problem with drug–drug interactions when initiating therapy with HCV medications. Rapid advances in HCV drug development led to the discovery of new classes of direct-acting antiviral (DAA) agents that target the HCV replication cycle. Several studies demonstrated comparable rates of sustained virological response (SVR) in coinfected and monoinfected patients with new DAA-based therapy.
Part of the book: Update on Hepatitis C