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Hepatitis C virus in human immunodeficiency virus-infected individuals: an emerging comorbidity with significant

Stevan A Gonzalez1, Andrew H Talal

  • 1Center for the Study of Hepatitis C and Department of Medicine, Weill Medical College of Cornell University, New York, New York10021, USA.

Seminars in Liver Disease
|June 12, 2003
PubMed

Insights

Hepatitis C virus (HCV) infection significantly impacts human immunodeficiency virus (HIV)-infected individuals, accelerating liver disease. Treatment for coinfected patients is complex, requiring further research into new therapies.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Immunology

Background:

  • Antiretroviral therapy (ART) effectiveness has increased survival for HIV-infected individuals.
  • Hepatitis C virus (HCV) infection is a major cause of illness and death in those with HIV.
  • HIV significantly alters HCV presentation, epidemiology, virology, and pathogenesis.

Purpose of the Study:

  • To review the impact of HIV on HCV infection.
  • To discuss challenges in treating HCV in coinfected individuals.
  • To explore future treatment strategies for HCV/HIV coinfection.

Main Methods:

  • Literature review of studies on HCV/HIV coinfection.
  • Analysis of clinical presentation, virology, and pathogenesis.
  • Evaluation of current and emerging HCV treatment regimens.

Main Results:

  • HIV accelerates HCV fibrosis progression, increases viral RNA levels, and hastens cirrhosis and end-stage liver disease (ESLD).
  • Standard HCV treatments (pegylated interferon alpha [PEG-IFN] and ribavirin [RBV]) show reduced efficacy and increased complications in coinfected individuals.
  • Newer, direct-acting antiviral regimens show promise but require further study in coinfected populations.

Conclusions:

  • HCV diagnosis and treatment are recommended for coinfected individuals.
  • Current HCV treatment in coinfection is challenging due to lower efficacy and higher complication rates.
  • Further research is crucial to optimize HCV treatment strategies for coinfected individuals, potentially involving novel agents and combinations.

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