Lee Winston, Dieterich Douglas
Mount Sinai Medical Center, 1 Gustave L. Levy Place, Box 1118, New York, NY 10029, USA.
Drugs. 2004;64(7):693-700. doi: 10.2165/00003495-200464070-00002.
Hepatitis C virus (HCV) has become a significant contributor to morbidity and mortality to those infected with HIV since the introduction of highly active antiretroviral therapy (HAART). The presence of HIV clearly has a negative effect on the natural history of HCV, although there is some debate over whether HCV influences the natural history of HIV. Given the prevalence of co-infection and the accelerated liver damage from HCV, treatment of chronic HCV infection is an important consideration in patients co-infected with HIV. There are few studies of pegylated interferon and ribavirin in co-infected populations, but it seems that the treatment is well tolerated, although it is possibly less effective in this group. HAART in the setting of HCV infection also requires some special consideration, namely an increased incidence of hepatotoxicity. Treatment of co-infected patients requires close monitoring as current therapies are not ideal in terms of effectiveness, and toxicity may be severe.
自高效抗逆转录病毒疗法（HAART）问世以来，丙型肝炎病毒（HCV）已成为感染人类免疫缺陷病毒（HIV）者发病和死亡的重要因素。HIV的存在显然对HCV的自然病程有负面影响，尽管对于HCV是否影响HIV的自然病程存在一些争议。鉴于合并感染的普遍性以及HCV导致的肝脏损害加速，慢性HCV感染的治疗是HIV合并感染者的一个重要考虑因素。关于聚乙二醇化干扰素和利巴韦林在合并感染人群中的研究较少，但似乎该治疗耐受性良好，尽管在这一群体中可能效果较差。在HCV感染情况下进行HAART也需要一些特殊考虑，即肝毒性发生率增加。合并感染患者的治疗需要密切监测，因为目前的疗法在有效性方面并不理想，而且毒性可能很严重。
