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Optimal therapy of HIV/HCV co‐infected patients with direct acting antivirals
Author(s) -
Rockstroh Jürgen K.
Publication year - 2015
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12721
Subject(s) - medicine , hepatitis c virus , hepatitis c , human immunodeficiency virus (hiv) , drug , decompensation , ribavirin , antiretroviral therapy , virology , immunology , viral load , virus , pharmacology
The development of direct acting antivirals ( DAA s) against the hepatitis C virus ( HCV ) has revolutionized treatment paradigms for HCV in HIV co‐infected subjects. In the era of DAA s, HIV / HCV co‐infected patients have the same cure rates of over 90% with interferon ( IFN )‐free DAA combinations. Therefore, guidelines no longer separate mono‐ and co‐infected subjects. Indications for HCV therapy and DAA drug selection have become the same for all patients. The only special consideration in HIV / HCV co‐infected subjects is the need to check for drug–drug interactions between HIV and HCV drugs, especially HIV and HCV protease inhibitors which have a high risk of clinically significant drug interactions. Because of the faster progression of fibrosis and the higher risk of hepatic decompensation in co‐infected subjects, even with combination antiretroviral ( ART ) therapy, the availability of modern HCV treatments needs to be extended and HCV therapy should be discussed in all co‐infected patients.