HCV chronic hepatitis in patients with HIV

Clinical management issues

Raffaele Bruno, Paolo Sacchi, Massimo Puoti, Vincente Soriano, Gaetano Filice

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

HIV-hepatitis C virus (HCV) coinfection is common and affects more than one-third of all HIV infected persons worldwide. Prevalence among risk categories varies according to shared risk factors for transmission, mainly intravenous drug use (IDU) and hemophiliacs. Chronic HCV infection seems to accelerate the course of HIV disease, resulting in a worsened clinical and immunological progression. At the same time, several studies suggest that HIV disease modifies the natural history of HCV infection, leading to a faster course of progression from active hepatitis to cirrhosis, to end stage liver disease and death. HCV infection mimics opportunistic diseases because its natural history is significantly accelerated in HIV patients. Since highly active antiretroviral therapy (HAART) has slowed the progression of HIV disease and decreased the rate of HIV associated mortality, the prognosis of HIV disease has been modified, and the need to treat HCV coinfection become a significant issue. Because of the poor response rate obtained by either interferon alone or interferon thrice weekly plus ribavirin, the combination of pegylated interferon and ribavirin will probably become the standard of care, although the clinicians should be aware of the overlapping toxicity of nucleoside analogues and ribavirin. Many selected categories of patients pose particular challenges to physicians treating HCV infection: Nonresponders to interferon, cirrhotic patients, and patients infected with both HCV and HBV. Liver transplantation in HIV patients is currently under evaluation, but should become the rescue therapy for HIV patients with end stage liver disease.

Original languageEnglish
Pages (from-to)1598-1606
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume97
Issue number7
DOIs
Publication statusPublished - 2002

Fingerprint

Chronic Hepatitis
Hepacivirus
HIV
Virus Diseases
Interferons
Ribavirin
End Stage Liver Disease
Natural History
Coinfection
Highly Active Antiretroviral Therapy
Chronic Hepatitis C
Standard of Care
Nucleosides
Liver Transplantation
Hepatitis
Disease Progression
Fibrosis
Physicians
Mortality

ASJC Scopus subject areas

  • Gastroenterology

Cite this

HCV chronic hepatitis in patients with HIV : Clinical management issues. / Bruno, Raffaele; Sacchi, Paolo; Puoti, Massimo; Soriano, Vincente; Filice, Gaetano.

In: American Journal of Gastroenterology, Vol. 97, No. 7, 2002, p. 1598-1606.

Research output: Contribution to journalArticle

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