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Hepatitis C Virus Infection in HIV-infected Patients
1Division of Infectious Diseases, Johns Hopkins Medical Institutions, 1830 East Monument Street, Room 319, Baltimore, MD 21287-0003, USA. msulkows@jhmi.edu
Insights
Hepatitis C virus (HCV) and HIV co-infection is common, accelerating liver disease progression and increasing risks. New strategies are urgently needed to prevent HCV infection and manage liver disease in co-infected individuals.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) is a significant cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma.
- HCV infection affects approximately 4 million people in the US, with 10,000 annual deaths.
- HCV and HIV co-infection is prevalent, impacting one-third of US HIV-infected individuals.
Purpose of the Study:
- To highlight the clinical significance of HCV/HIV co-infection.
- To emphasize the accelerated liver disease progression in co-infected individuals.
- To underscore the urgent need for prevention and management strategies for HCV in HIV-infected persons.
Main Methods:
- Literature review on HCV and HIV co-infection epidemiology and clinical impact.
- Analysis of shared transmission routes and their implications.
- Evaluation of HCV's effect on HIV disease progression and management.
Main Results:
- HIV co-infection is associated with higher HCV viral load and faster progression to cirrhosis.
- HCV infection can increase the risk of antiretroviral drug-induced hepatotoxicity.
- Chronic HCV functions as an opportunistic disease in HIV-infected individuals.
Conclusions:
- HCV/HIV co-infection accelerates liver disease and increases mortality risk.
- Effective strategies for HCV prevention and liver disease management are critical for co-infected individuals.
- Understanding the interplay between HCV and HIV is essential for improved patient outcomes.
Abstract:
The hepatitis C virus (HCV) is a spherical enveloped RNA virus of the Flaviviridae family, classified within the Hepacivirus genus. Since its discovery in 1989, HCV has been recognized as a major cause of chronic hepatitis and hepatic fibrosis that progresses in some patients to cirrhosis and hepatocellular carcinoma. In the United States, approximately 4 million people have been infected with HCV, and 10,000 HCV-related deaths occur each year. Due to shared routes of transmission, HCV and HIV co-infection are common, affecting approximately one third of all HIV-infected persons in the United States. In addition, HIV co-infection is associated with higher HCV RNA viral load and a more rapid progression of HCV-related liver disease, leading to an increased risk of cirrhosis. HCV infection may also impact the course and management of HIV disease, particularly by increasing the risk of antiretroviral drug-induced hepatotoxicity. Thus, chronic HCV infection acts as an opportunistic disease in HIV-infected persons because the incidence of infection is increased and the natural history of HCV infection is accelerated in co-infected persons. Strategies to prevent primary HCV infection and to modify the progression of HCV-related liver disease are urgently needed among HIV/HCV co-infected individuals.
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