Management issues in patients coinfected with hepatitis C virus and HIV.
Coinfection with HIV accelerates the progression of hepatitis C toward advanced liver disease. Low CD4+ cell counts may result in false-negative results on all diagnostic tests except hepatitis C virus (HCV) RNA assays, which are the gold standard for viral replication. First-line management of HIV-HCV--coinfected patients should be optimization of HAART, because low CD4+ cell counts have been associated with greater fibrosis. In addition, agents used to treat hepatitis C may lower CD4+ cell counts and hemoglobin levels. Long-acting interferons offer the promise of better sustained HCV response in HIV-HCV coinfection.
Bonacini
Maurizio
M
Division of Gastroenterology and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, USA.
D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D022362:Hepatitis A Vaccines / Q000008:administration & dosage; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use; D014611:Vaccination
D000998:Antiviral Agents; D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons