Treatment of chronic hepatitis C in patients with HIV/HCV coinfection

• 作者: Caterina Sagnelli Evangelista Sagnelli Mariantonietta Pisaturo Nicola Coppola Pietro Filippini Salvatore Martini
• 来源期刊: 世界病毒学杂志
• 学科: 医学
• 关键词: HEPATITIS C VIRUS INFECTION Human immunodeficiency VIRUS INFECTION Anti-hepatitis C VIRUS TREATMENT Directly acting antivirals HIV/HCV COINFECTION Chronic HEPATITIS C
• 年，卷（期）: 2015,（1）
• 页码范围: 1-12
• 页数: 12页
• 分类号: R

摘要

Hepatitis C virus(HCV)infection is one of the most frequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV)population,and liver-related mortality is now the second highest cause of death in HIV-positive patients,so HCV infection should be countered with adequate antiviral therapy.In 2011 began the era of directly acting antivirals(DAAs)and the HCV NS3/4A protease inhibitors telaprevir and boceprevir were approved to treat HCV-genotype-1 infection,each one in combination with pegylated interferon alfa(Peg-IFN)+ribavirin(RBV).The addition of the first generation DAAs,strongly improved the efficacy of antiviral therapy in patients with HCVgenotype 1,both for the HCV-monoinfected and HIV/HCV coinfected,and the poor response to Peg-IFN+RBV in HCV/HIV coinfection was enhanced.These treatments showed higher rates of sustained virological response than Peg-IFN+RBV but reduced tolerability and adherence due to the high pill burden and the several pharmacokinetic interactions between HCV NS3/4A protease inhibitors and antiretroviral drugs.Then in 2013 a new wave of DAAs arrived,characterized by high efficacy,good tolerability,a low pill burden and shortened treatment duration.The second and third generation DAAs also comprised IFN-free regimens,which in small recent trials on HIV-positive patients have shown comforting preliminary results in terms of efficacy,tolerability and adherence.