Management of hepatitis C virus infection in HIV/HCV co-infected patients: Clinical review

Abstract

N e a r l y o n e fo u r t h o f i n d i v i d u a l s w i t h h u m a n immunodeficiency virus (HIV) infection have hepatitis C virus (HCV) infection in the US and Western Europe. With the availability of highly active antiretroviral therapy and the consequent reduction in opportunistic infections, resulting in the prolongation of the life span of HIV-infected patients, HCV co-infection has emerged as a significant factor influencing the survival of HIV patients. Patients with HIV/HCV co-infection have a faster rate of fibrosis progression resulting in more frequent occurrences of cirrhosis, end-stage liver disease, and hepatocellular carcinoma. However, the mechanism of interaction between the two viruses is not completely understood. The treatment for HCV in co-infected patients is similar to that of HCV monoinfection; i.e., a combination of pegylated interferon and ribavirin. The presence of any barriers to anti-HCV therapy should be identified and eliminated in order to recruit all eligible patients. The response to treatment in co-infected patients is inferior compared to the response in patients with HCV mono-infection. The sustained virologic response rate is only 38% for genotype-1 and 75% for genotype-2 and -3 infections. Liver transplantation is no longer considered a contraindication for end-stage liver disease in coinfected patients. However, the 5 year survival rate is lower in co-infected patients compared to patients with HCV mono-infection (33% vs 72%, P = 0.07). A better understanding of liver disease in co-infected patients is needed to derive new strategies for improving outcome and survival.

Biological applications of functionalized calixarenes

“…189,190 Recently, Hamilton et al reported the potent compounds 110-120 based on a tetrabutoxy-calix [4]arene scaffold that possesses dual inhibition for both HIV and HCV. The potency of the compounds is due to the aromatic isophthalate spacers and diacid groups at the upper rim for anti-HIV activities and anti-HCV effects, respectively.…”

Multiple Infections and Cancer: Implications in Epidemiology

“…Further, the treatment response in co-infected patients is significantly lower, with the 5-year survival rate decreasing from 72% in mono-infected individuals to 33% in co-infected individuals (204). The interaction between HBV/HCV and HIV and its impact on liver injury is unclear.…”

“…In the United States, it is estimated that 25% of HIV patients are infected with HCV, and 7%-10% are infected with HBV as well (204,205). The prevalence of HCV in HIV patients who acquire infection through intravenous drug abuse or multiple blood transfusions is 75%-90% (24,206).…”

HCV In At Risk Populations: Who Can be Treated and How?

“…Amalgamated data from seven randomized controlled or prospective studies showed an overall SVR rate of 33% in co-infected patients [63], clearly lower than those with HCV monoinfection.…”