Update in HIV–hepatitis C virus coinfection in the direct acting antiviral era

Abstract

Purpose of Review Availability of direct acting antivirals (DAAs) that demonstrate remarkable clinical efficacy and safety has revolutionized the ability to treat chronic infection with hepatitis C virus (HCV). An equal measure of clinical success has now been achieved in persons co-infected with HCV and the human immunodeficiency virus (HIV), a historically harder to cure cohort with interferon-based therapy. Global goals include identifying all HIV/HCV-infected persons, gaining access to DAA-therapy, preventing de novo and re-infection, and managing the sequelae of chronic infection. This review will discuss advances in the field of HIV/HCV co-infection reported during the last 18 months, and will suggest areas for future investigation. Recent Findings An expanding body of literature has enhanced our understanding of the clinical and epidemiologic issues surrounding HIV/HCV co-infection. DAA therapy for HCV is highly efficacious in HIV/HCV co-infected persons if drug-drug interactions are appropriately considered. Summary Eradicating HCV infection in persons with HIV co-infection can be achieved safely and effectively with available DAAs. Economic and social approaches to enable access and delivery of curative HCV therapy to HIV-infected persons require continued research and resource allocation.

Dynamics of hepatitis C epidemic among people living with HIV in Estonia

“…It is important to note that despite the reduction of HIV infection among PWID almost all HIV positive PWID are still infected with HCV suggesting that decline of HCV infection among PWID can only been achieved by significant reduction of circulation of HCV in the community. It is hoped that this will happen after new DAAs for treatment of chronic HCV infection are made available to all patients including PWID and HIV/HCV co-infected patients (25,26). According to our study as of end of 2015 only 5% of patients with HCV were receiving anti-HCV treatment similar to other Eastern European countries (27,28).…”

Dynamics of hepatitis C epidemic among people living with HIV in Estonia

“…It is important to note that despite the reduction of HIV infection among PWID almost all HIV positive PWID are still infected with HCV suggesting that decline of HCV infection among PWID can only been achieved by significant reduction of circulation of HCV in the community. It is hoped that this will happen after new DAAs for treatment of chronic HCV infection are made available to all patients including PWID and HIV/HCV co-infected patients (25,26). According to our study as of end of 2015 only 5% of patients with HCV were receiving anti-HCV treatment similar to other Eastern European countries (27,28).…”

The Era of DAAs: Assessing the Patients’ Characteristics, Clinical Impact, and Emergence of Comorbidities in HIV/HCV-Coinfected versus HIV-Infected Individuals

“…Given the availability of IFN-free therapies, the SVR12 rate observed for PLWH with HCV demonstrates the success of the treatment, which is also similar to the rate observed in patients without infection by HIV [65]. Clearing HCV not only confers a proven clinical benefit in PLWH [66] but also improves patient-reported outcomes [67], even in patients with significant liver impairment [68]. Moreover, the interaction between HIV treatments and DAAs is easily managed in most cases and does not interfere with HCV clearance [49].…”

Hepatitis C virus genotypes in patients with chronic hepatitis C infection in southern Iran from 2016 to 2019

“…In HIV+ patients, the HCV viral load means were higher than in other risk groups, but this variable was not statistically significant. This may be related to the low number of HIV+ patients among the study population 21‐23 . In conclusion, genotype 1 is the predominant type among HCV genotypes and it affects 48.8% of the patients, followed by G3a (47.2%).…”

“…This may be related to the low number of HIV+ patients among the study population. [21][22][23] In conclusion, genotype 1 is the predominant type among HCV genotypes and it affects 48.8% of the patients, followed by G3a (47.2%). Our study results have indicated that in the study area the genotype distribution is similar to other parts of Iran.…”

Dynamics of hepatitis C epidemic among people living with HIV in Estonia

“…It is important to note that despite the reduction of HIV infection among PWID almost all HIV positive PWID are still infected with HCV suggesting that decline of HCV infection among PWID can only been achieved by significant reduction of circulation of HCV in the community. It is hoped that this will happen after new DAAs for treatment of chronic HCV infection are made available to all patients including PWID and HIV/HCV co-infected patients (25,26). According to our study as of end of 2015 only 5% of patients with HCV were receiving anti-HCV treatment similar to other Eastern European countries (27,28).…”

The Era of DAAs: Assessing the Patients’ Characteristics, Clinical Impact, and Emergence of Comorbidities in HIV/HCV-Coinfected versus HIV-Infected Individuals

“…Given the availability of IFN-free therapies, the SVR12 rate observed for PLWH with HCV demonstrates the success of the treatment, which is also similar to the rate observed in patients without infection by HIV [65]. Clearing HCV not only confers a proven clinical benefit in PLWH [66] but also improves patient-reported outcomes [67], even in patients with significant liver impairment [68]. Moreover, the interaction between HIV treatments and DAAs is easily managed in most cases and does not interfere with HCV clearance [49].…”

Hepatitis C virus genotypes in patients with chronic hepatitis C infection in southern Iran from 2016 to 2019

“…In HIV+ patients, the HCV viral load means were higher than in other risk groups, but this variable was not statistically significant. This may be related to the low number of HIV+ patients among the study population 21‐23 . In conclusion, genotype 1 is the predominant type among HCV genotypes and it affects 48.8% of the patients, followed by G3a (47.2%).…”

“…This may be related to the low number of HIV+ patients among the study population. [21][22][23] In conclusion, genotype 1 is the predominant type among HCV genotypes and it affects 48.8% of the patients, followed by G3a (47.2%). Our study results have indicated that in the study area the genotype distribution is similar to other parts of Iran.…”

Dynamics of hepatitis C epidemic among people living with HIV in Estonia

“…It is important to note that despite the reduction of HIV infection among PWID almost all HIV positive PWID are still infected with HCV suggesting that decline of HCV infection among PWID can only been achieved by significant reduction of circulation of HCV in the community. It is hoped that this will happen after new DAAs for treatment of chronic HCV infection are made available to all patients including PWID and HIV/HCV co-infected patients (25,26). According to our study as of end of 2015 only 5% of patients with HCV were receiving anti-HCV treatment similar to other Eastern European countries (27,28).…”

The Era of DAAs: Assessing the Patients’ Characteristics, Clinical Impact, and Emergence of Comorbidities in HIV/HCV-Coinfected versus HIV-Infected Individuals

“…Given the availability of IFN-free therapies, the SVR12 rate observed for PLWH with HCV demonstrates the success of the treatment, which is also similar to the rate observed in patients without infection by HIV [65]. Clearing HCV not only confers a proven clinical benefit in PLWH [66] but also improves patient-reported outcomes [67], even in patients with significant liver impairment [68]. Moreover, the interaction between HIV treatments and DAAs is easily managed in most cases and does not interfere with HCV clearance [49].…”

Hepatitis C virus genotypes in patients with chronic hepatitis C infection in southern Iran from 2016 to 2019

“…In HIV+ patients, the HCV viral load means were higher than in other risk groups, but this variable was not statistically significant. This may be related to the low number of HIV+ patients among the study population 21‐23 . In conclusion, genotype 1 is the predominant type among HCV genotypes and it affects 48.8% of the patients, followed by G3a (47.2%).…”

“…This may be related to the low number of HIV+ patients among the study population. [21][22][23] In conclusion, genotype 1 is the predominant type among HCV genotypes and it affects 48.8% of the patients, followed by G3a (47.2%). Our study results have indicated that in the study area the genotype distribution is similar to other parts of Iran.…”