title: Direct-acting antiviral-based therapy for acute hepatitis C coinfection.
abstract: OBJECTIVE
  Modern interferon (IFN)-free, and potentially also ribavirin-free, combinations consisting of two or three direct-acting antivirals (DAAs) are highly efficacious in treating chronic hepatitis C virus (HCV) infection with treatment durations being much shorter and with much more favorable toxicity profiles. With the acute HCV (AHC) epidemic among men who have sex with men (MSM) still ongoing, the question remains should we be using DAAs in the acute phase of the infection?
  
  
  RESULTS
  To date, none of the currently available DAAs has been licensed for use in the setting of AHC infection. Thus, the current gold standard of treatment still is a combination of pegylated interferon (pegIFN) and weight-adapted ribavirin (RBV). However, with less patients being treated in the acute phase, the current epidemic of AHC in HIV-positive MSM will continue.
  
  
  CONCLUSIONS
  A decision to treat AHC with pegIFN and RBV can currently only be made on an individual basis in an open discussion between patient and physician which will need to weigh up the risk and benefits of a rather toxic and lengthy treatment now versus the likely available options in the chronic phase. Therefore, studies with IFN-free DAA combinations remain of great urgency to further evaluate the role of DAAs in the treatment of AHC.
authors.affiliation: aDepartment of Medicine I, Bonn University Hospital, Bonn, Germany bDepartment of Sexual Health, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Christoph
authors.initials: C
authors.lastname: Boesecke
authors.forename: Emma
authors.initials: E
authors.lastname: Page
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy* / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male
chemical_list: D000998:Antiviral Agents