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Natural history and treatment of HCV/HIV coinfection: Is it time to change paradigms?

  • Author Footnotes
    † Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).
    Joop E. Arends
    Correspondence
    Corresponding author. Address: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Huispostnummer F.02.126, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Tel.: +31 88 7571180; fax: +31 88 7555639.
    Footnotes
    † Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).
    Affiliations
    Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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  • Faydra I. Lieveld
    Affiliations
    Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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  • Lauke L. Boeijen
    Affiliations
    Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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  • Clara T.M.M. de Kanter
    Affiliations
    Department of Clinical Pharmacy, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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  • Karel J. van Erpecum
    Affiliations
    Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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  • Author Footnotes
    † Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).
    Dominique Salmon
    Footnotes
    † Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).
    Affiliations
    Department of Infectious Diseases, Hôpital Cochin, Paris, France
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  • Author Footnotes
    † Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).
    Andy I.M. Hoepelman
    Footnotes
    † Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).
    Affiliations
    Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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  • Tarik Asselah
    Affiliations
    Service d’Hépatologie, Hôpital Beaujon, AP-HP, Clichy, and INSERM, UMR1149, Labex INFLAMEX, Université Denis Diderot Paris 7, France
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  • Andrew Ustianowski
    Affiliations
    Regional Infectious Diseases Unit, North Manchester General Hospital, Manchester, United Kingdom
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  • Author Footnotes
    † Members of the European Study Group on Viral Hepatitis (ESGVH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).

      Summary

      Evidence over the past decades have shown that HIV/HCV coinfected patients did not respond as well to HCV therapy as HCV mono-infected patients. However, these paradigms are being recently reassessed with the improvements of care for HIV and HCV patients. This article reviews these original paradigms and how the new data is impacting upon them. Treatment efficacy now appears comparable for HIV/HCV coinfected and HCV mono-infected patients, while liver fibrosis progression is increasingly similar in optimally managed patients. Additional importance of therapy is directed to drug-drug interactions and the impact of HCV reinfection, as well as the possibility of transmitted drug resistance.

      Abbreviations:

      HCV (hepatitis C virus), HIV (human immunodeficiency virus), MSM (men who have sex with men), iv (intravenous), PegIFNα (pegylated interferon-alfa), RBV (ribavirin), SVR (sustained virological response), GT (genotype), DAA (direct-acting antiviral), NS3 (nonstructural protein 3), SOF (sofosbuvir), LDV (ledipasvir), DAC (daclatasvir), CROI (Conference on Retroviruses and Opportunistic Infections), EASL ILC (European Association for the Study of the Liver Study International Liver Conference), cART (combination antiretroviral therapy), NNRTI (non-nucleoside reverse transcriptase inhibitor), PIs (protease inhibitors), P-gp (P-glycoprotein), BCRP (breast cancer resistance protein), HCC (hepatocellular carcinoma), ddI (didanosine), d4T (stavudine), HBV (hepatitis B virus)

      Keywords

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