An Epidemiologic Update on Hepatitis C Infection in Persons Living With or at Risk of HIV Infection

Abstract

Due to shared routes of transmission, coinfection with both human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) is relatively common and results in accelerated liver disease, driving morbidity and mortality. Deaths related to HCV now exceed deaths related to HIV in the United States, and co-infected patients bear a significant proportion of that mortality. This burden may be addressed by novel antiviral therapies that promise increased rates of cure or by enhanced access to liver transplantation, but these are costly interventions. Ultimately, the future burden of coinfection is addressed by greater understanding of who is at risk for development of each infection, thus guiding preventive efforts. Key recent reports regarding the US burden of morbidity and mortality due to HCV and groups at risk for coinfection are reviewed, with a focus on recently described HCV occurring among young injection drug users and men who have sex with men. Given the lack of available vaccine against HCV, enhanced detection and surveillance is a vital component of our public health strategy to combat HCV.

Adherence to Screening Guidelines for Hepatitis C Among HIV-Positive Patients

“…The percentage of all HIV infected people who also have HCV ranges from 15% to 30%, and one study reported that 37% of people with HIV were co-infected with HCV. 1,2 Unrecognized HIV/HCV co-infection has serious implications on liver health, as it may accelerate the progression of HCV liver disease. 1,2 Early detection of people co-infected with HIV and HCV is essential in managing treatment of these infections.…”

“…1,2 Unrecognized HIV/HCV co-infection has serious implications on liver health, as it may accelerate the progression of HCV liver disease. 1,2 Early detection of people co-infected with HIV and HCV is essential in managing treatment of these infections. Thus in 2009, the European Aids Clinical Society (EACS) guidelines 3 introduced the notion of systematic annual HCV screening among HIV-infected patients.…”

Coinfection with Hepatitis C Virus among HIV-1-Infected Individuals Increases Proinflammatory Cytokines and HIV-1 Disease Severity

“…The interplay between both the viruses is complex and usually leads to accelerated forms of HIV-1 disease as well as HCV disease [21]. In fact, some recent reports have suggested that HCV-related deaths are greater than HIV-1-related deaths in the United States, and that the HIV-1/HCV co-infected individuals are the ones bearing a significant portion of the mortality [40]. Accelerated liver disease, higher viral loads, and differential therapeutic regimens are some of the specific challenges encountered during HIV-1/HCV coinfection.…”

Neues bei HIV und Neuro-Aids

“…In Deutschland sind ca. 10 000 (15 % aller HIV-Patienten), in den USA 240 000 (30 % aller HIV-Infizierten) mit HCV koinfiziert [73]. Die wenigsten dieser Patienten sind adäquat therapiert und es wird angenommen, dass eine HCV-Koinfektion mit einem beschleunigten Verlauf der HIV-Infektion bei unbehandelten Patienten assoziiert sein könnte [74].…”