[Role of tenofovir in HIV and hepatitis C virus coinfection].
Chronic hepatitis C virus (HCV) infection is common in HIV-infected individuals, especially if the route of infection is intravenous (e.g. intravenous drug use or blood transfusion). Prognosis is poorer in patients with HCV and HIV coinfection than in those with HCV monoinfection, mainly due to the immunodepression caused by HIV infection and probably also to a direct effect of HIV on the liver. Moreover, although antiretroviral therapy can cause liver damage, there is little doubt about the net benefits obtained with triple therapy in coinfected individuals, since suppression of HIV replication and immune recovery help to halt liver damage. However, not all antiretroviral agents are equal and those with the lowest hepatotoxicity and best metabolic profile should be used in coinfected patients, since hepatic steatosis accelerates progression of hepatic fibrosis and insulin resistance hampers the success of treatment with interferon and ribavirin. Tenofovir is currently one of the safest nucleos(t)ide analogues, due to its low hepatotoxicity and its lack of negative interference on treatment of HCV infection.
Tuma
Paula
P
Servicio de Enfermedades Infecciosas, Hospital Carlos III, Madrid, España.
Vispo
Eugenia
E
Barreiro
Pablo
P
Soriano
Vicente
V
D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000517:prevention & control; D018450:Disease Progression; D004342:Drug Hypersensitivity / Q000150:complications / Q000209:etiology; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005234:Fatty Liver / Q000139:chemically induced / Q000517:prevention & control; D044882:Glucose Metabolism Disorders / Q000139:chemically induced / Q000150:complications; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D007372:Interferons / Q000493:pharmacokinetics / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects / Q000821:virology; D008103:Liver Cirrhosis / Q000209:etiology / Q000517:prevention & control; D063065:Organophosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000068698:Tenofovir
D019380:Anti-HIV Agents; D000998:Antiviral Agents; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D012254:Ribavirin; D007372:Interferons; D000068698:Tenofovir; D000225:Adenine