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Therapeutic issues in HIV/HCV-coinfected patients

The importance of treating hepatitis C virus (HCV)-associated morbidities in a growing population of patients coinfected with human immunodeficiency virus (HIV) has increased since the introduction of highly active antiretroviral therapy. As a result, investigative attention is turning to HCV-relate...

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Detalles Bibliográficos
Autores principales: Sulkowski, M S, Benhamou, Y
Formato: Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974798/
https://www.ncbi.nlm.nih.gov/pubmed/17501757
http://dx.doi.org/10.1111/j.1365-2893.2006.00816.x
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author Sulkowski, M S
Benhamou, Y
author_facet Sulkowski, M S
Benhamou, Y
author_sort Sulkowski, M S
collection PubMed
description The importance of treating hepatitis C virus (HCV)-associated morbidities in a growing population of patients coinfected with human immunodeficiency virus (HIV) has increased since the introduction of highly active antiretroviral therapy. As a result, investigative attention is turning to HCV-related liver disease and treatment-associated issues in coinfection. HIV/HCV-coinfected patients have higher HCV RNA loads and show more rapid progression of fibrosis than do monoinfected patients. Combination therapy with pegylated interferon plus ribavirin (RBV) is the standard of care for HCV in coinfected patients. Therapy slows fibrosis progression, but toxicity prevents identification of the most effective RBV dose. Coinfected patients have about a threefold greater risk of antiretroviral therapy-associated hepatotoxicity than patients with HIV only. Other challenges include anaemia, mitochondrial toxicity, drug–drug interactions and leucopenia. Thus, chronic hepatitis C should be treated in HIV/HCV-coinfected patients, but steps must be taken to prevent and treat potential toxicities. The first European Consensus Conference on the Treatment of Chronic Hepatitis B and C in HIV Co-infected Patients was held March 2005 in Paris to address these issues. This article reviews the peer-reviewed literature and expert opinion published from 1990 to 2005, and compares results with presentations and recommendations from the Consensus Conference to best present current issues in coinfection.
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spelling pubmed-19747982007-09-18 Therapeutic issues in HIV/HCV-coinfected patients Sulkowski, M S Benhamou, Y J Viral Hepat Review The importance of treating hepatitis C virus (HCV)-associated morbidities in a growing population of patients coinfected with human immunodeficiency virus (HIV) has increased since the introduction of highly active antiretroviral therapy. As a result, investigative attention is turning to HCV-related liver disease and treatment-associated issues in coinfection. HIV/HCV-coinfected patients have higher HCV RNA loads and show more rapid progression of fibrosis than do monoinfected patients. Combination therapy with pegylated interferon plus ribavirin (RBV) is the standard of care for HCV in coinfected patients. Therapy slows fibrosis progression, but toxicity prevents identification of the most effective RBV dose. Coinfected patients have about a threefold greater risk of antiretroviral therapy-associated hepatotoxicity than patients with HIV only. Other challenges include anaemia, mitochondrial toxicity, drug–drug interactions and leucopenia. Thus, chronic hepatitis C should be treated in HIV/HCV-coinfected patients, but steps must be taken to prevent and treat potential toxicities. The first European Consensus Conference on the Treatment of Chronic Hepatitis B and C in HIV Co-infected Patients was held March 2005 in Paris to address these issues. This article reviews the peer-reviewed literature and expert opinion published from 1990 to 2005, and compares results with presentations and recommendations from the Consensus Conference to best present current issues in coinfection. Blackwell Publishing Ltd 2007-06-01 /pmc/articles/PMC1974798/ /pubmed/17501757 http://dx.doi.org/10.1111/j.1365-2893.2006.00816.x Text en © 2007 The Authors Journal compilation © 2007 Blackwell Publishing Ltd
spellingShingle Review
Sulkowski, M S
Benhamou, Y
Therapeutic issues in HIV/HCV-coinfected patients
title Therapeutic issues in HIV/HCV-coinfected patients
title_full Therapeutic issues in HIV/HCV-coinfected patients
title_fullStr Therapeutic issues in HIV/HCV-coinfected patients
title_full_unstemmed Therapeutic issues in HIV/HCV-coinfected patients
title_short Therapeutic issues in HIV/HCV-coinfected patients
title_sort therapeutic issues in hiv/hcv-coinfected patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974798/
https://www.ncbi.nlm.nih.gov/pubmed/17501757
http://dx.doi.org/10.1111/j.1365-2893.2006.00816.x
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