Department of Medicine, Brown University, Providence, RI 02906, USA.
Clin Infect Dis. 2012 Jul;55 Suppl 1(Suppl 1):S33-42. doi: 10.1093/cid/cis367.
Chronic hepatitis C virus (HCV) infection has become a major threat to the survival of human immunodeficiency virus (HIV)-infected persons in areas where antiretroviral therapy is available. In coinfection, viral eradication has been difficult to attain, and HCV therapy is underused. Novel therapies may be particularly beneficial for this population, yet studies lag behind those for HCV monoinfection. Increasingly, incident HCV among HIV-infected men who have sex with men is associated with sexual risk behavior further research should be performed to refine understanding of the causal mechanism of this association. The phenomenon of aggressive hepatic fibrogenesis when HIV infection precedes HCV acquisition requires longer-term observation to ensure optimal timing of HCV therapy. Medical management in coinfection will be improved by enhancing HCV detection, with annual serologic testing, screening with HCV RNA to detect acute infection, and HIV testing of HCV-infected individuals; by addressing HCV earlier in coinfected persons; and by universal consideration for HCV therapy. HCV drug trials in individuals coinfected with HIV should be expedited. HIV/HCV coinfection remains a growing and evolving epidemic; new developments in therapeutics and improved care models offer promise.
慢性丙型肝炎病毒（HCV）感染已成为在提供抗逆转录病毒治疗的地区中，感染艾滋病毒（HIV）人群生存的主要威胁。在合并感染中，病毒清除一直难以实现，且 HCV 治疗的应用不足。新疗法可能对这一人群特别有益，但研究落后于 HCV 单感染。在 HIV 感染者中，新发生的与男男性行为相关的 HCV 感染与性风险行为相关，应该进一步研究以完善对这种关联的因果机制的理解。当 HIV 感染先于 HCV 感染时，会出现侵袭性肝纤维化，需要进行更长期的观察，以确保 HCV 治疗的最佳时机。通过增强 HCV 检测、每年进行血清学检测、用 HCV RNA 筛查急性感染以及对 HCV 感染者进行 HIV 检测，可改进合并感染中的医疗管理；通过在合并感染者中更早地处理 HCV，以及普遍考虑 HCV 治疗，可改进合并感染中的医疗管理。应该加快在 HIV 合并感染个体中进行 HCV 药物试验。HIV/HCV 合并感染仍是一个不断发展的流行问题；治疗方法的新进展和改进的护理模式带来了希望。
