title: HIV and hepatitis C co-infection:  acute HCV therapy.
abstract: OBJECTIVE
  Almost 10 years ago clinicians started to note first cases of an outbreak of acute hepatitis C (AHC) infections among HIV-positive men who have sex with men (MSM) in Europe, soon followed by similar reports from the USA and Australia. To date, no randomized controlled treatment trials in AHC co-infection have been conducted. However, to give clinicians guidance in best clinical management of these patients expert consensus recommendations based upon published data from uncontrolled clinical and cohort studies have recently been published.
  
  
  RESULTS
  The early course of hepatitis C virus (HCV) RNA in the first 4 weeks after diagnosis is considered to be a helpful predictor of spontaneous clearance of AHC in HIV-infected individuals. Additionally, single-nucleotide polymorphisms near the IL28B gene further augment chances of spontaneous clearance. Pegylated interferon in combination with weight-adapted ribavirin is still recommended as treatment of choice for all HCV genotypes. For patients developing a rapid virological response (RVR), defined as a negative HCV-RNA in an ultrasensitive assay, treatment duration of 24 weeks is recommended. If antiviral therapy was initiated within 24 weeks after diagnosis high sustained virological response (SVR) rates of 60-80% have been observed.
  
  
  CONCLUSIONS
  Prevention and screening efforts along with early anti-HCV therapy have to be intensified to allow control of viral dissemination as the current epidemic of AHC particularly among MSM is still ongoing. Concise recommendations for best clinical management of AHC in HIV infection on the basis of published observational data have been published.
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany. christoph.boesecke@ukb.uni-bonn.de
authors: Christoph
authors: C
authors: Boesecke
authors: Martin
authors: M
authors: Vogel
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D060085:Coinfection; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D018451:Homosexuality, Male; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: 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