Recommendations for the use of hepatitis C virus protease inhibitors for the treatment of chronic hepatitis C in HIV-infected persons. A position paper of the Italian Association for the Study of Infectious and Tropical Disease.
The efficacy data obtained with boceprevir and telaprevir for persons with hepatitis C virus (HCV) genotype 1 infection raise the question of whether HCV protease inhibitors should be used in human immunodeficiency virus (HIV)/HCV co-infected persons. The Italian Association for the Study of Infectious and Tropical Diseases has made these recommendations to provide the rationale and practical indications for the use of triple anti-HCV therapy in persons living with HIV (PLWHIV). A Writing Committee of experts indicated by the President of the Association and a Consulting Committee con- tributed to the document. The final draft was submitted to the evaluation of external experts and the text modified according to their suggestions and comments. Treatment of HCV co-infection should be considered for all HCV RNA positive PLWHIV. Response-guided therapy with pegylated interferon and ribavirin is the standard treatment of PLWHIV with infection by HCV genotype 2, 3, 4, 5 and 6. Boceprevir and telaprevir should be used to treat HCV genotype 1 infection in HIV/HCV co-infected patients for 48 weeks on an individual basis, with close monitoring of their efficacy and tolerability with concur- rent antiretroviral therapy, taking into account potential drug-drug interactions. The decision to treat a patient or to wait for better treatment options, or to discontinue treatment should be made on an individual basis taking into account pre-treatment variables and the on-treatment HCV RNA kinetics.
Infectious Disease Unit, Belcolle Hospital, Viterbo, Italy.
Orlando
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Armignacco
Massimo
M
Andreoni
Evangelista
E
Sagnelli
Massimo
M
Puoti
Raffaele
R
Bruno
Giovanni Battista
GB
Gaeta
Carlo F
CF
Perno
Teresa A
TA
Santantonio
Paolo
P
Bonfanti
Stefano
S
Bonora
Marco
M
Borderi
Antonella
A
Castagna
Antonella
A
d'Arminio Monforte
Andrea
A
De Luca
Paolo
P
Grossi
Giovanni
G
Guaraldi
Franco
F
Maggiolo
Cristina
C
Mussini
Caterina
C
Sagnelli
Marcello
M
Tavio
Carlo
C
Torti
Caterina
C
Uberti-Foppa
Massimo
M
Andreoni
Gioacchino
G
Angarano
Andrea
A
Antinori
Orlando
O
Armignacco
Giampiero
G
Carosi
Antonio
A
Chirianni
Giovanni
G
Di Perri
Massimo
M
Galli
Adriano
A
Lazzarin
Giuliano
G
Rizzardini
Evangelista
E
Sagnelli
Gloria
G
Taliani
D006801:Humans; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000188:drug therapy / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects / Q000502:physiology; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000821:virology; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D007558:Italy; D059065:Medication Reconciliation; D011480:Protease Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D000998:Antiviral Agents; D011480:Protease Inhibitors