[Management of C virus infection in patients coinfected with HIV treated with antiretroviral agents].
BACKGROUND
The prevalence of hepatitis C virus (HCV) infection in patients infected by the human immunodeficiency virus (HIV) varies from 10 to 30%, depending on the mode of contamination, and reaches about 80% in intravenous drug users and hemophiliacs. The two viral infections can be treated simultaneously or, on the contrary, one may be given priority depending on the respective pathological or viral situations.
HCV infection does not appear to affect the natural course of HIV infection. Inversely, HIV infection aggravates HCV infection by amplifying HCV replication. This leads to a risk of more severe liver disease and a more rapid progression to cirrhosis. Mortality in HIV-infected patients is higher. This points to the importance of early diagnosis and treatment aimed at avoiding progression to potentially severe liver disease. The impact of highly effective anti-HIV tritherapy regimens, particularly restoration of immune competence, and of drug-induced hepatitis on the natural history of HCV infection should be taken into consideration when making management decisions concerning implementation of antiretroviral or anti-hepatitis C treatments.


CONCLUSIONS
The long-term efficacy of alpha-interferon given in a single-drug regimen has been mediocre. New perspectives have appeared with the development of new treatments, particularly the ribavirin-alpha-interferon combination or the development of delayed-release alpha-interferon.
Pol
S
S
Service d'Hépatologíe, Hôpital Necker, 149, rue de Sèvres, F 75743 Paris. stanislas.pol@nck.ap-hop-paris.fr
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans
D019380:Anti-HIV Agents