Hepatitis C virus and HIV coinfection: clinical management and new strategies.
Approximately one third of all HIV-infected people are coinfected with hepatitis C virus (HCV). The progression from initial HCV infection to cirrhosis of the liver is accelerated in coinfected patients compared with HCV-monoinfected patients. Because of improved therapies for HIV/AIDS, one of the leading causes of death for HIV-infected patients is liver disease. It is therefore important to screen all persons with HIV infection for the presence of HCV and to treat the HCV infection as appropriate. Treatment options need to be tailored to each patient, depending on the severity of liver damage, the HCV genotype, and the willingness of the patient to receive therapy. Current first-line therapy for hepatitis C consists of pegylated interferon plus ribavirin. However, this therapy has only limited success in persons with HCV genotype 1 and in African Americans. In addition, the side effects of anti-HCV therapy can be considerable and require careful management. Improvement or delayed progression of fibrosis should be the main goal of therapy in most patients.
Alvarez
Daniel F
DF
Division of HIV/AIDS Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Latorre
Juan S
JS
D001741:Black or African American; D000465:Algorithms; D019380:Anti-HIV Agents / Q000009:adverse effects; D002986:Clinical Trials as Topic; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000473:pathology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
D019380:Anti-HIV Agents; D007372:Interferons