New drug targets for HIV and hepatitis C virus coinfection.
Current interferon (IFN)-based therapies for hepatitis C in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) may be limited by incomplete virological response, lack of adherence, and poor tolerability. Newer therapies for hepatitis C will target viral replication (e.g., HCV serine protease inhibitors, helicase inhibitors, RNA interference, or an HCV polymerase inhibitor). Other treatments will focus on viral translation (e.g., antisense molecules). Additions to IFN therapy that can modulate the immune response (e.g., thymosin, isatorbine, or injectable histamine) may improve tolerability of treatment. There need to be targets that minimize the inflammatory response by the liver (e.g., IFN-gamma). There are some therapeutic vaccines in early development. Drugs to replace or enhance ribavirin are being studied with IFN-based treatments. Strategic treatment trials that address sequencing of HCV and HIV therapy with current and future therapeutic agents and combination therapy need to be undertaken.
Tedaldi
Ellen M
EM
Comprehensive HIV Program, Temple University School of Medicine, Philadelphia, PA 19140, USA. etedaldi@temple.edu
D016503:Drug Delivery Systems / Q000639:trends; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D016174:Hepacivirus / Q000187:drug effects / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology; D007372:Interferons / Q000187:drug effects / Q000494:pharmacology; D012254:Ribavirin / Q000494:pharmacology; D014761:Viral Hepatitis Vaccines; D014779:Virus Replication / Q000187:drug effects
D007155:Immunologic Factors; D014761:Viral Hepatitis Vaccines; D012254:Ribavirin; D007372:Interferons