Document Detail

Management of patients coinfected with HCV and HIV: a close look at the role for direct-acting antivirals.
MedLine Citation:
PMID:  22537439     Owner:  NLM     Status:  MEDLINE    
With the development of effective therapies against human immunodeficiency virus (HIV), hepatitis C virus (HCV) infection has become a major cause of morbidity and mortality among patients with both infections (coinfection). In addition to the high prevalence of chronic HCV, particularly among HIV-infected injection drug users, the rate of incident HIV infections is increasing among HIV-infected men who have sex with men, leading to recommendations for education and screening for HCV in this population. Liver disease is the second leading and, in some cases, a preventable cause of death among coinfected patients. Those at risk for liver disease progression are usually treated with a combination of interferon (IFN) and ribavirin (RBV), which is not highly effective; it has low rates of sustained virologic response (SVR), especially for coinfected patients with HCV genotype 1 and those of African descent. Direct-acting antivirals might overcome factors such as immunodeficiency that can reduce the efficacy of IFN. However, for now it remains challenging to treat coinfected patients due to interactions among drugs, additive drug toxicities, and the continued need for combination therapies that include pegylated IFN. Recently developed HCV protease inhibitors such as telaprevir and boceprevir, given in combination with pegylated IFN and RBV, could increase the rate of SVR with manageable toxicity and drug interactions. We review the latest developments and obstacles to treating coinfected patients.
Susanna Naggie; Mark S Sulkowski
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Gastroenterology     Volume:  142     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-27     Completed Date:  2012-06-18     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1324-1334.e3     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Adenine / analogs & derivatives,  therapeutic use
Anti-HIV Agents / therapeutic use
Antiviral Agents / adverse effects,  pharmacokinetics,  pharmacology*,  therapeutic use*
Deoxycytidine / analogs & derivatives,  therapeutic use
Dideoxynucleosides / therapeutic use
Disease Progression
Drug Administration Schedule
Drug Interactions
Drug Therapy, Combination
HIV Infections / drug therapy*,  epidemiology,  etiology
Hepatitis C, Chronic / drug therapy*,  epidemiology,  etiology
Homosexuality, Male
Interferon-alpha / therapeutic use
Lamivudine / therapeutic use
Liver Cirrhosis / virology
Liver Diseases / prevention & control,  virology*
Oligopeptides / therapeutic use
Organophosphonates / therapeutic use
Polyethylene Glycols / therapeutic use
Proline / analogs & derivatives,  therapeutic use
Pyrrolidinones / therapeutic use
Recombinant Proteins / therapeutic use
Ribavirin / therapeutic use
Serine Proteinase Inhibitors / therapeutic use
Substance Abuse, Intravenous / complications
Treatment Outcome
Grant Support
DA-16065/DA/NIDA NIH HHS; K23 AI096913/AI/NIAID NIH HHS; K23-AI096913-02/AI/NIAID NIH HHS; K24 DA034621/DA/NIDA NIH HHS; R01 DA016065/DA/NIDA NIH HHS; R01 DA016065-10/DA/NIDA NIH HHS
Reg. No./Substance:
0/Anti-HIV Agents; 0/Antiviral Agents; 0/Dideoxynucleosides; 0/Interferon-alpha; 0/N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; 0/Oligopeptides; 0/Organophosphonates; 0/Polyethylene Glycols; 0/Pyrrolidinones; 0/Recombinant Proteins; 0/Serine Proteinase Inhibitors; 0/emtricitabine; 0/peginterferon alfa-2a; 0/telaprevir; 0W860991D6/Deoxycytidine; 107021-12-5/tenofovir; 22VKV8053U/raltegravir; 2T8Q726O95/Lamivudine; 49717AWG6K/Ribavirin; 9DLQ4CIU6V/Proline; JAC85A2161/Adenine; WR2TIP26VS/abacavir

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