title: Treatment of chronic hepatitis C in patients with HIV/HCV coinfection.
abstract: Hepatitis C virus (HCV) infection is one of the most frequent causes of comorbidity and mortality in the human immunodeficiency virus (HIV) population, and liver-related mortality is now the second highest cause of death in HIV-positive patients, so HCV infection should be countered with adequate antiviral therapy. In 2011 began the era of directly acting antivirals (DAAs) and the HCV NS3/4A protease inhibitors telaprevir and boceprevir were approved to treat HCV-genotype-1 infection, each one in combination with pegylated interferon alfa (Peg-IFN) + ribavirin (RBV). The addition of the first generation DAAs, strongly improved the efficacy of antiviral therapy in patients with HCV-genotype 1, both for the HCV-monoinfected and HIV/HCV coinfected, and the poor response to Peg-IFN + RBV in HCV/HIV coinfection was enhanced. These treatments showed higher rates of sustained virological response than Peg-IFN + RBV but reduced tolerability and adherence due to the high pill burden and the several pharmacokinetic interactions between HCV NS3/4A protease inhibitors and antiretroviral drugs. Then in 2013 a new wave of DAAs arrived, characterized by high efficacy, good tolerability, a low pill burden and shortened treatment duration. The second and third generation DAAs also comprised IFN-free regimens, which in small recent trials on HIV-positive patients have shown comforting preliminary results in terms of efficacy, tolerability and adherence.
authors: Nicola Coppola, Salvatore Martini, Mariantonietta Pisaturo, Pietro Filippini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors: Nicola
authors: N
authors: Coppola
authors: Nicola Coppola, Salvatore Martini, Mariantonietta Pisaturo, Pietro Filippini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors: Salvatore
authors: S
authors: Martini
authors: Nicola Coppola, Salvatore Martini, Mariantonietta Pisaturo, Pietro Filippini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors: Mariantonietta
authors: M
authors: Pisaturo
authors: Nicola Coppola, Salvatore Martini, Mariantonietta Pisaturo, Pietro Filippini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors: Caterina
authors: C
authors: Sagnelli
authors: Nicola Coppola, Salvatore Martini, Mariantonietta Pisaturo, Pietro Filippini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors: Pietro
authors: P
authors: Filippini
authors: Nicola Coppola, Salvatore Martini, Mariantonietta Pisaturo, Pietro Filippini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors: Evangelista
authors: E
authors: Sagnelli
keywords: Anti-hepatitis C virus treatment; Chronic hepatitis C; Directly acting antivirals; HIV/HCV coinfection; Hepatitis C virus infection; Human immunode-ficiency virus infection