title: CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment.
abstract: Background. Hepatitis C virus (HCV) coinfection occurs in 20-30% of Canadians living with HIV and is responsible for a heavy burden of morbidity and mortality. Purpose. To update national standards for management of HCV-HIV coinfected adults in the Canadian context with evolving evidence for and accessibility of effective and tolerable DAA therapies. The document addresses patient workup and treatment preparation, antiviral recommendations overall and in specific populations, and drug-drug interactions. Methods. A standing working group with HIV-HCV expertise was convened by The Canadian Institute of Health Research HIV Trials Network to review recently published HCV antiviral data and update Canadian HIV-HCV Coinfection Guidelines. Results. The gap in sustained virologic response between HCV monoinfection and HIV-HCV coinfection has been eliminated with newer HCV antiviral regimens. All coinfected individuals should be assessed for interferon-free, Direct Acting Antiviral HCV therapy. Regimens vary in content, duration, and success based largely on genotype. Reimbursement restrictions forcing the use of pegylated interferon is not acceptable if optimal patient care is to be provided. Discussion. Recommendations may not supersede individual clinical judgement. Treatment advances published since December 2015 are not considered in this document.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, University of British Columbia, Vancouver, BC, Canada V6T 1Z4.
authors.forename: Mark
authors.initials: M
authors.lastname: Hull
authors.affiliation: University of Alberta, Edmonton, AB, Canada T6G 2R3.
authors.forename: Stephen
authors.identifier: 0000-0002-4617-0908
authors.initials: S
authors.lastname: Shafran
authors.affiliation: Regina Qu'Appelle Health Region, Regina, SK, Canada S4P 1E2.
authors.forename: Alex
authors.initials: A
authors.lastname: Wong
authors.affiliation: Toronto General Hospital, Toronto, ON, Canada M5G 2C4.
authors.forename: Alice
authors.initials: A
authors.lastname: Tseng
authors.affiliation: The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6.
authors.forename: Pierre
authors.initials: P
authors.lastname: Giguère
authors.affiliation: Dalhousie University, Halifax, NS, Canada B3H 4R2.
authors.forename: Lisa
authors.initials: L
authors.lastname: Barrett
authors.affiliation: McMaster University, Hamilton, ON, Canada L8S 4L8.
authors.forename: Shariq
authors.initials: S
authors.lastname: Haider
authors.affiliation: Vancouver Infectious Diseases Centre, Vancouver, BC, Canada V6Z 2C7.
authors.forename: Brian
authors.initials: B
authors.lastname: Conway
authors.affiliation: McGill University, Montreal, QC, Canada H3A 0G4.
authors.forename: Marina
authors.initials: M
authors.lastname: Klein
authors.affiliation: The Ottawa Hospital, General Campus, G12, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6.
authors.forename: Curtis
authors.initials: C
authors.lastname: Cooper