title: Advances in therapy for HIV/hepatitis C virus-coinfected patients in the liver transplant setting.
abstract: Complications of cirrhosis due to hepatitis C virus (HCV) are increasing, and liver transplantation (LT) is the most effective treatment for those with liver decompensation or small hepatocellular carcinoma. However, for patients with human immunodeficiency virus (HIV) coinfection, barriers to LT exist. This is related to the poorer survival rates post-LT (55% at 5 years) and, up until this year, the limited options for treating those coinfected LT recipients with progressive recurrent HCV disease, the commonest reason for reduced survival. The newly approved antiviral therapies sofosbuvir and simeprevir, with significantly improved efficacy and markedly better safety and tolerability in HIV and transplant patients, offer the opportunity to transform the outcomes of HIV/HCV-coinfected patients with liver complications. Additional new therapies, anticipated within the year, are expected to further simplify the management of coinfected patients in the transplant setting.
authors.affiliation: Division of Gastroenterology and Hepatology, University of California, San Francisco.
authors.forename: Isabel
authors.initials: I
authors.lastname: Campos-Varela
authors.affiliation: Division of Gastroenterology and Hepatology, University of California, San Francisco.
authors.forename: Marion G
authors.initials: MG
authors.lastname: Peters
authors.affiliation: Division of Gastroenterology and Hepatology, University of California, San Francisco.
authors.forename: Norah A
authors.initials: NA
authors.lastname: Terrault
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000379:methods / Q000639:trends; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006575:Heterocyclic Compounds, 3-Ring / Q000627:therapeutic use; D006801:Humans; D016031:Liver Transplantation; D000069616:Simeprevir; D000069474:Sofosbuvir; D013449:Sulfonamides / Q000627:therapeutic use; D014542:Uridine Monophosphate / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D006575:Heterocyclic Compounds, 3-Ring; D013449:Sulfonamides; D000069616:Simeprevir; D014542:Uridine Monophosphate; D000069474:Sofosbuvir
keywords: direct-acting antivirals; drug–drug interaction; hepatitis C virus; human immunodeficiency virus; liver transplant