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Optimum combination therapy regimens for HIV/HCV infection
David Rey1, Patrice Muret2, Lionel Piroth3
1a Le Trait d'Union, Center for HIV Care, NHC , Hôpitaux Universitaires , Strasbourg , France.
Expert Review of Anti-Infective Therapy
|January 30, 2016
Summary
HIV-HCV co-infection impacts specific populations, with poorer prognosis but slower progression to liver complications with optimized antiretroviral therapy (ARV). Hepatitis C treatment is recommended, often achieving eradication with direct-acting antivirals (DAAs).
Area of Science:
- Infectious Diseases
- Hepatology
- Virology
Background:
- HIV-HCV co-infection predominantly affects intravenous drug users, with decreasing prevalence, but increasing incidence in men who have sex with men.
- Hepatitis C (HCV) presents a poorer prognosis in HIV co-infected individuals, characterized by accelerated clinical progression and advanced hepatic fibrosis.
- Optimized antiretroviral therapy (ARV) significantly slows the progression of liver complications in HIV-HCV co-infected patients.
Purpose of the Study:
- To review the current landscape of HIV-HCV co-infection, focusing on epidemiological shifts and clinical outcomes.
- To highlight the impact of optimized ARV treatment on liver disease progression in co-infected patients.
- To discuss treatment strategies for hepatitis C in the context of HIV co-infection, including drug interactions and treatment guidelines.
Main Methods:
- Literature review of epidemiological trends in HIV-HCV co-infection.
- Analysis of clinical outcomes and disease progression in co-infected patients.
- Examination of treatment guidelines and pharmacological considerations for direct-acting antivirals (DAAs) in HIV-HCV co-infected individuals.
Main Results:
- Prevalence trends show a decrease in intravenous drug users and an increase in men who have sex with men, with a rise in acute hepatitis C.
- Optimized ARV treatment is associated with slower progression to hepatic complications.
- Numerous drug interactions exist between HCV and HIV medications, necessitating careful pharmacological consultation.
Conclusions:
- Hepatitis C treatment should be offered to all HIV-HCV co-infected patients, aligning with international guidelines.
- HCV eradication is achievable in most patients using various direct-acting antiviral (DAA) combinations.
- Treatment decisions for DAAs are guided by HCV genotype, fibrosis stage, and prior treatment history.
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