title: Management of Hepatitis C/HIV Coinfection in the Era of Highly Effective Hepatitis C Virus Direct-Acting Antiviral Therapy.
abstract: The increased life expectancy of persons infected with human immunodeficiency virus (HIV) treated with antiretroviral therapy (ART) has resulted in renewed attention to non-HIV-related diseases exacerbated by HIV infection. Coinfection with hepatitis C virus (HCV) is a particular area of concern, as the global prevalence has been estimated at 2.5-5 million people. In this article, we discuss the epidemiology of HCV infection and reinfection, HCV-related liver disease progression in the era of effective ART, and the efficacy of emerging HCV treatment strategies in persons with HIV/HCV coinfection. New data regarding treatment of persons with HIV/HCV coinfection suggest that HCV treatment should be a priority in those with HIV. Results from recent studies using all-oral HCV regimens have shown high rates of sustained virologic response in both clinical trials and real-world settings. A multidisciplinary approach to HCV treatment in those with HIV is recommended for optimal patient management. Following HCV cure, practitioners also need to be mindful of the risks for HCV reinfection and educate patients on protective measures.
authors.affiliation: Divisions of Infectious Diseases, Department of Medicine, University of California, San Diego.
authors.forename: David L
authors.initials: DL
authors.lastname: Wyles
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Sulkowski
authors.affiliation: Division of Liver Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Douglas
authors.initials: D
authors.lastname: Dieterich
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection; D019468:Disease Management; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D017410:Practice Guidelines as Topic
chemical_list: D000998:Antiviral Agents
keywords: HCV; HIV; HIV/HCV coinfection; direct acting-antivirals (DAAs); hepatitis C