Hepatitis C virus infection in HIV-infected patients.
Because of shared routes of transmission, hepatitis C and HIV coinfection is common in the United States, affecting 15% to 30% of HIV-infected individuals. In the era of highly effective antiretroviral therapy, hepatitis C virus (HCV)-related liver disease has emerged as a significant cause of morbidity and mortality. Accordingly, the Infectious Diseases Society of America and the American Association for the Study of Liver Disease guidelines for the management of HCV recommend that patients with HIV/HCV undergo medical evaluation for HCV-related liver disease and consideration for HCV treatment and, if indicated, orthotopic liver transplantation. However, the treatment of patients with HIV/HCV is complicated by the relatively high prevalence of medical and psychiatric comorbidities and the challenges of anti-HCV therapy in the setting of HIV disease and antiretroviral therapy. Nonetheless, recently completed randomized controlled trials provide evidence of the safety, tolerability, and efficacy of HCV treatment with pegylated interferon-alpha plus ribavirin in HIV-infected individuals. This review focuses on the epidemiology, natural history, and management of HCV in the HIV-infected patient.
Sulkowski
Mark S
MS
Division of Infectious Diseases, Johns Hopkins Medical Institutions, 1830 East Monument Street, Room 319, Baltimore, MD 21287, USA. msulkows@jhmi.edu
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy / Q000635:transmission; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015897:Comorbidity; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy / Q000635:transmission; D006526:Hepatitis C / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy / Q000635:transmission; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016031:Liver Transplantation
D044966:Anti-Retroviral Agents; D000998:Antiviral Agents