Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Liver Int. 2012 Feb;32 Suppl 1:129-34. doi: 10.1111/j.1478-3231.2011.02719.x.
As a result of shared modes of transmission, chronic hepatitis C infection is common in HIV-infected patients, particularly among those who have used injection drugs as well as men who have sex with men (MSMs). In the era of effective antiretroviral therapy, HCV infection has emerged as a major cause of morbidity and mortality worldwide. Over the last decade, treatment with peginterferon (PEG-IFN) plus ribavirin (RBV) has been recommended for coinfected patients who are at the greatest risk for liver disease; however, the effectiveness of HCV treatment in this population has been disappointing. Challenges to the use of HCV NS3/4A protease inhibitors, telaprevir and boceprevir, patients with HIV/HCV coinfection include the potential for interactions between different drugs, addition of drug toxicities, and the need for therapy with PEG-IFN. Despite these challenges, limited data indicate that telaprevir and boceprevir given in combination with PEG-IFN/RBV increase the rate of viral suppression in coinfected patients with manageable toxicity and drug-drug interaction profile. Accordingly, these agents may be recommended for HCV treatment in carefully selected HIV-infected persons.
由于传播模式相同，慢性丙型肝炎感染在感染艾滋病毒的患者中很常见，特别是在那些使用注射毒品以及男男性行为者（MSM）中。在有效的抗逆转录病毒治疗时代，HCV 感染已成为全球发病率和死亡率的主要原因。在过去十年中，建议对患有肝病风险最大的合并感染患者使用聚乙二醇干扰素（PEG-IFN）加利巴韦林（RBV）进行治疗；然而，这种人群中 HCV 治疗的效果并不理想。HCV NS3/4A 蛋白酶抑制剂替拉瑞韦和博赛泼维在 HIV/HCV 合并感染患者中的应用面临着多种药物相互作用、药物毒性增加以及需要联合使用 PEG-IFN 的治疗等挑战。尽管存在这些挑战，但有限的数据表明，替拉瑞韦和博赛泼维与 PEG-IFN/RBV 联合使用可提高合并感染患者的病毒抑制率，且毒性和药物相互作用可管理。因此，这些药物可能被推荐用于精心选择的 HIV 感染者的 HCV 治疗。
