title: Natural history and treatment of HCV/HIV coinfection: Is it time to change paradigms?
abstract: Evidence over the past decades have shown that HIV/HCV coinfected patients did not respond as well to HCV therapy as HCV mono-infected patients. However, these paradigms are being recently reassessed with the improvements of care for HIV and HCV patients. This article reviews these original paradigms and how the new data is impacting upon them. Treatment efficacy now appears comparable for HIV/HCV coinfected and HCV mono-infected patients, while liver fibrosis progression is increasingly similar in optimally managed patients. Additional importance of therapy is directed to drug-drug interactions and the impact of HCV reinfection, as well as the possibility of transmitted drug resistance.
authors.affiliation: Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands. Electronic address: j.e.arends@umcutrecht.nl.
authors.forename: Joop E
authors.initials: JE
authors.lastname: Arends
authors.affiliation: Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: Faydra I
authors.initials: FI
authors.lastname: Lieveld
authors.affiliation: Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: Lauke L
authors.initials: LL
authors.lastname: Boeijen
authors.affiliation: Department of Clinical Pharmacy, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: Clara T M M
authors.initials: CT
authors.lastname: de Kanter
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: Karel J
authors.initials: KJ
authors.lastname: van Erpecum
authors.affiliation: Department of Infectious Diseases, Hôpital Cochin, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon
authors.affiliation: Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: Andy I M
authors.initials: AI
authors.lastname: Hoepelman
authors.affiliation: Service d'Hépatologie, Hôpital Beaujon, AP-HP, Clichy, and INSERM, UMR1149, Labex INFLAMEX, Université Denis Diderot Paris 7, France.
authors.forename: Tarik
authors.initials: T
authors.lastname: Asselah
authors.affiliation: Regional Infectious Diseases Unit, North Manchester General Hospital, Manchester, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ustianowski
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection; D019468:Disease Management; D006678:HIV; D015658:HIV Infections / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D016174:Hepacivirus; D006526:Hepatitis C / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D006801:Humans; D013997:Time Factors
chemical_list: D000998:Antiviral Agents
keywords: Direct-acting antiviral agents; HIV; Hepatitis C; Liver fibrosis; Pegylated interferon