Therapy of hepatitis C in HIV-coinfection.
One third of all European and American HIV-patients are coinfected with hepatitis C. HIV accelerates hepatitis C virus liver disease especially when HIV-associated immune deficiency progresses. Indeed, liver cirrhosis rate is five times higher in HIV/HCV-coinfected patients than in HCV-monoinfected patients. With the introduction of pegylated interferon and ribavirin combination therapy sustained virological response rates of up to 40 % could be obtained in HIV/HCV-coinfected individuals. Moreover, cohort analyses could demonstrate that with the use of highly active antiretroviral therapy (HAART) an improved course of hepatitis C and a reduction in liver disease-associated mortality can be achieved. Under consideration of the increased rate of hepatotoxicity due to the presently available antiretroviral treatment regimens in HIV/HCV coinfected patients, however, the development of treatment strategies and guidelines for management of hepatitis coinfection in HIV remains of great clinical significance.
Rockstroh
J K
JK
Medizinische Universitätsklinik I, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany. rockstroh@uni-bonn.de
Vogel
M
M
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005060:Europe / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects / Q000473:pathology; D012254:Ribavirin / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons