Coinfection with HIV and HCV: More Questions than Answers?

Waldrep, Travis W.; Summers, Kimberly K.; Chiliade, Philippe

doi:10.1592/phco.20.19.1499.34859

Cited by 12 publications

(4 citation statements)

References 66 publications

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“…In the United States, it is estimated that 30-35% of the 800,000 HIV-infected persons are coinfected with HCV, even though some geographical variations have been emphasized by different authors [25,26].…”

Section: Transmission Routes and Epidemiologymentioning

confidence: 99%

Human Immunodeficiency Virus and Hepatitis C Virus Coinfection: Epidemiology, Natural History, Therapeutic Options and Clinical Management

et al. 2004

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Due to shared risk factors for transmission, coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a very common event. The prevalence of HCV infection among HIV-positive patients averages about 35% in the United States and Europe, but in clinical populations where there is a great prevalence of intravenous drug use as a risk factor for acquiring HIV, this value may be as high as 80-90%. Several studies have confirmed that HIV coinfection accelerates the natural course of chronic hepatitis C and an increased risk of liver cirrhosis, hepatocellular carcinoma, and decompensated liver disease has been found in coinfected subjects. Other studies have shown an increased risk of progression to acquired immunodeficiency syndrome (AIDS) and AIDS-related death among HIV-HCV-positive persons, suggesting that HCV coinfection may accelerate the course of HIV disease. In addition, hepatitis C may affect the management of HIV infection, increasing the incidence of liver toxicity associated with the antiretroviral regimens. The optimal therapeutic approach to HCV infection in HIV coinfected patients is still uncertain, because of the complex pathogenesis of both infections, potential drugdrug interactions, and the poor literature and information available about safety and efficacy of an interferon (IFN) and ribavirin combination in this clinical population. Available data show that the sustained virological response rates in coinfected persons treated with standard IFN plus ribavirin range from 18-40%, and several studies with pegylated IFN plus ribavirin are ongoing.

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Section: Transmission Routes and Epidemiologymentioning

confidence: 99%

Human Immunodeficiency Virus and Hepatitis C Virus Coinfection: Epidemiology, Natural History, Therapeutic Options and Clinical Management

et al. 2004

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“…Numerous studies show that HIV infection determines a faster and more frequent progression of HCV-related chronic hepatitis with a consequent high risk of liver cirrhosis, hepatic failure and hepatocellular carcinoma [2,4,10,16,38,42,[44][45][46][47][48][49][50][51]. There is a case report of a very rapid progression of hepatitis C (cirrhosis within 2 years from disease onset) after simultaneous HIV/HCV coinfection [52].…”

Section: Hiv and Hcv: Physiopathology And Evolutionmentioning

confidence: 99%

HIV and Hepatitis C Virus: Facts and Controversies

et al. 2003

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Hepatitis C virus (HCV) infection occurs in about one-third of HIV-seropositive patients and in about 90% of HIVpositive drug abusers. After the introduction of highly active antiretroviral therapy (HAART) and the subsequent reduction in mortality from opportunistic infections, HCV-related liver failure has become a frequent cause of death in HIV-positive patients. In HIV-seropositive patients, the course of HCV infection is accelerated and there is evidence that HCV is an important factor for HIV progression. Consequently, it is important to establish the appropriate treatment for HCV infection in HIV-seropositive patients. This review examines the epidemiology, physiopathology, diagnostics and treatment of HIV/HCV coinfection with particular regard to the impact of HAART.

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“…Some studies have demonstrated faster HIV disease progression among coinfected patients; however, many studies, including large epidemiologic investigations, have not reported a similar interaction [5]. Based on current data, mortality due to chronic HCV infection continues to be a leading cause of death in coinfected patients despite access to highly active antiretroviral therapy [6]. Not surprisingly, coinfection is now recognized as a leading cause of morbidity and mortality in HIV [5].…”

Section: Introductionmentioning

confidence: 99%