title: Effect of coinfection with hepatitis C virus on survival of individuals with HIV-1 infection.
abstract: Hepatitis C virus (HCV) coinfection is a common and an important comorbidity in HIV infection. We review current trends in mortality and the potential for early combination antiretroviral therapy (cART) and HCV therapy to improve survival in coinfected patients.
  
  
  
  HIV/HCV coinfection increases risk of death from all causes, and from liver disease and harmful drug use in particular. There is growing evidence for a direct role of HIV in liver fibrogenesis and for cART to decrease the risk of dying from liver disease in coinfected persons. Sustained virologic responses after HCV treatment greatly impact mortality by reducing rates of hepatic decompensation, hepatocellular carcinoma and death from liver-related and nonliver-related causes by at least 50%, but treatment uptake has been low so far. Recent epidemiologic studies do suggest that liver-related mortality is declining in recent calendar periods; however, methodological limitations of currently available studies are important.
  
  
  
  Early cART and wider HCV treatment have the potential to markedly reduce HCV-related mortality and thus increase survival overall for HIV-infected populations. However, HCV treatment will need to be greatly scaled up. Given the complex nature of the populations affected, future studies will need to be carefully designed and controlled to rigorously evaluate the impact of these revolutionary therapies on survival.
authors.affiliation: aDivision of Infectious Diseases/Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, CanadabDepartment of Medicine I, University Hospital Bonn, Bonn, GermanycUniversity Bordeaux, ISPEDdINSERM, Centre INSERM U1219eCHU de Bordeaux, Pole de sante publique, Bordeaux, France.
authors.forename: Marina B
authors.initials: MB
authors.lastname: Klein
authors.forename: Jürgen K
authors.initials: JK
authors.lastname: Rockstroh
authors.forename: Linda
authors.initials: L
authors.lastname: Wittkop
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000188:drug therapy / Q000401:mortality*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D015994:Incidence; D055502:Secondary Prevention; D016019:Survival Analysis
chemical_list: D000998:Antiviral Agents