Management of hepatitis C/HIV coinfection.
OBJECTIVE
One third of HIV-infected individuals in Europe and the USA have a hepatitis C coinfection. With the introduction of highly active antiretroviral therapy for treatment of HIV, liver disease caused by chronic hepatitis C virus infection has now become an increasingly important cause of morbidity and mortality among HIV-infected patients. Therefore, treatment strategies for management of hepatitis C coinfection in HIV-infected individuals are urgently needed.


RESULTS
With the introduction of pegylated interferon/ribavirin combination therapy significantly improved treatment options for HIV/hepatitis C virus-coinfected patients have become available, leading to sustained virological response rates of over 40%. Increasing knowledge on the management of adverse events under hepatitis C therapy and optimized selection of antiretrovirals in HIV/hepatitis C virus-coinfected patients has helped to reduce complications and improve overall treatment outcome.


CONCLUSIONS
Treatment with pegylated interferon plus ribavirin is safe and effective in HIV/hepatitis C virus-coinfected patients. Longer treatment durations of 48 weeks are recommended for genotype 2 or 3. Positive predictive factors for sustained response are hepatitis C virus genotype 2 or 3 and early treatment response.
Rockstroh
Jürgen K
JK
Department of Medicine I, University of Bonn, Bonn, Germany. rockstroh@uni-bonn.de
D000998:Antiviral Agents / Q000627:therapeutic use*; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D016174:Hepacivirus / Q000145:classification / Q000187:drug effects / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a