[Coinfection with hepatitis C virus and HIV].
The life expectancy of patients with an HIV infection has improved dramatically since the introduction of highly active anti-retroviral therapy (HAART). Retrospective studies have shown that since then, hospital admissions and mortality caused by a co-infection with hepatitis C virus (HCV) have increased. Patients with an HIV-HCV co-infection exhibit on average a more rapid progression to liver cirrhosis and liver failure than patients with an HCV monoinfection. It is expected that a co-infection with HCV will lead to serious complications among some of the HIV-infected population. It is therefore recommended that all HIV-infected patients be screened for a co-infection with HCV. The treatment of an HCV co-infection needs to be considered. The first choice therapy will probably be a combination of peginterferon and ribavirin, although final conclusions about the safety and efficacy are still awaited. A combination of ribavirin with zidovudine or didanosine is best avoided. Developments being made with new classes of drugs, such as HCV-specific protease inhibitors and polymerase inhibitors, seem promising.
Ruys
Th A
TA
Afd. Inwendige Geneeskunde, onderafd. Infectieziekten, Tropische Geneeskunde en Aids, Academisch Medisch Centrum/Universiteit van Amsterdam, Postbus 22.660, 1100 DD Amsterdam. t.ruys@amc.uva.nl
Reesink
H W
HW
Lange
J M
JM
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D016896:Treatment Outcome
D000998:Antiviral Agents