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Minerva Gastroenterologica e Dietologica 2014 September;60(3):165-75

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Management of hepatitis C virus and human immunodeficiency virus coinfection

O’neil C. R. 1, Coffin C. S. 1, 2

1 Department of Internal Medicine, Faculty of Medicine, University of Calgary, Calgary, Canada; 2 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Calgary, Calgary, Canada


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With the success of highly active antiretroviral therapy in treating HIV, liver disease has emerged as a major cause of morbidity and mortality amongst HCV and HIV coinfected patients. Until recently, the treatment of HCV in HIV positive patients with interferon based regimens and/or first generation directly acting antiviral agents (DAAs) yielded lower sustained virological response (SVR) rates compared to HCV monoinfected patients and treatment was limited by significant side effects and drug-drug interactions. The introduction of second generation DAAs has led to a remarkable improvement in treatment outcomes of HCV/HIV coinfected patients with >90% achieving a SVR with relatively simple and short treatment courses and with minimal adverse effects. In this article, we provide a comprehensive overview of the epidemiology, diagnosis, approach to screening, and treatment of HIV/HCV coinfected patients. We focus particularly on the use of DAAs in this historically difficult to treat HCV-positive patient population.

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cscoffin@ucalgary.ca