Hepatitis C virus and human immunodeficiency virus: a dangerous dealing.
It is estimated that, in the United States and Europe, 15-30% of people with human immunodeficiency virus (HIV) are coinfected with hepatitis C virus (HCV). Among these patients, approximately 80% are intravenous drug users (IVDU), 71% are hemophiliacs, and around 20% are homosexual/bi-sexual men. HIV infection accelerates the natural history of HCV infection. On the contrary, highly active antiretroviral therapy reduces the rate of mortality due to liver disease by immune restoration. Since having HIV implies being at risk also for HCV as both infections can be acquired in similar ways, all individuals with the former should be screened for the latter. Loss of antibodies against HCV in HIV-seropositive IVDU has been shown. Thus, quantitative tests determining HCV-RNA levels in blood are currently being employed for diagnosis confirmation in case of an obvious ''risk group''. Since HIV can progress more rapidly than HCV, it may be preferable to treat HIV first. The 2007 recommendations from HCV-HIV International Panel indicate current treatment of HCV in coinfected patients with pegylated formulation of interferon at standard doses plus weight based ribavirin. The treatment duration should be evaluated on the basis of HCV genotype. Liver transplantation is a most debated issue when dealing with HCV/HIV coinfected subjects. Mortality among HIV-infected liver transplant recipients is similar to that of age and race-matched HIV-negative controls. The present concise review attempts to highlight on the current clinical situation on HIV/HCV coinfection.
Pellicano
R
R
Department of Gastro-Hepatology, Molinette Hospital, Turin, Italy. rinaldo_pellican@hotmail.com
Fagoonee
S
S
Repici
A
A
Rizzetto
M
M
D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans