title: Optimal therapy of HIV/HCV co-infected patients with direct acting antivirals.
abstract: The development of direct acting antivirals (DAAs) against the hepatitis C virus (HCV) has revolutionized treatment paradigms for HCV in HIV co-infected subjects. In the era of DAAs, HIV/HCV co-infected patients have the same cure rates of over 90% with interferon (IFN)-free DAA combinations. Therefore, guidelines no longer separate mono- and co-infected subjects. Indications for HCV therapy and DAA drug selection have become the same for all patients. The only special consideration in HIV/HCV co-infected subjects is the need to check for drug-drug interactions between HIV and HCV drugs, especially HIV and HCV protease inhibitors which have a high risk of clinically significant drug interactions. Because of the faster progression of fibrosis and the higher risk of hepatic decompensation in co-infected subjects, even with combination antiretroviral (ART) therapy, the availability of modern HCV treatments needs to be extended and HCV therapy should be discussed in all co-infected patients.
authors.affiliation: Department of Internal Medicine I, Bonn University Hospital, Bonn, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany.
authors.forename: Jürgen K
authors.initials: JK
authors.lastname: Rockstroh
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy*; D004347:Drug Interactions / Q000502:physiology*; D004359:Drug Therapy, Combination / Q000379:methods* / Q000639:trends; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy*; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D018579:Patient Selection
chemical_list: D000998:Antiviral Agents
keywords: HIV; cirrhosis; direct acting antivirals; hepatis C; liver disease