Hospital Universitario de Valme, Unit of Infectious Diseases and Microbiology , Avda. de Bellavista. 41014 Sevilla , Spain +34 955015684 ; +34 955315795 ;
Expert Opin Pharmacother. 2014 Sep;15(13):1837-48. doi: 10.1517/14656566.2014.934810. Epub 2014 Aug 1.
Hepatitis C virus (HCV)/HIV-coinfected patients are at an increased risk of progression of liver disease. Consequently, they benefit most from sustained virological response (SVR) to treatment against HCV. However, SVR rates to pegylated IFN plus ribavirin are disappointingly low in HIV/HCV coinfection. Nevertheless, therapy against HCV is rapidly changing due to the advent of directly acting antiviral drugs against HCV (DAA). Now, high SVR rates can be obtained in HIV/HCV coinfection with DAA regimens.
Data on DAAs in advanced stages of development in HIV/HCV coinfection, those that have entered Phase III clinical trials in this particular subset, are summarized. A search of clintrials.gov was done to identify DAAs entering Phase III trials that included HIV/HCV-coinfected patients.
HCV cure is possible in a high proportion of HIV-coinfected patients with currently available DAA. Caveats of first-generation DAAs are mostly solved by next-generation DAAs. Thus, all-oral regimens under development may be close to the ideal HCV therapy for HIV-coinfected patients. However, the elevated cost of newer DAAs can limit their access.
丙型肝炎病毒（HCV）/HIV 合并感染患者的肝脏疾病进展风险增加。因此，他们从针对 HCV 的持续病毒学应答（SVR）治疗中获益最大。然而，聚乙二醇化干扰素加利巴韦林治疗 HIV/HCV 合并感染的 SVR 率令人失望地低。尽管如此，由于直接作用抗病毒药物（DAA）针对 HCV 的出现，针对 HCV 的治疗正在迅速改变。现在，使用 DAA 方案可以在 HIV/HCV 合并感染中获得高 SVR 率。
总结了 HIV/HCV 合并感染中处于开发后期的 DAA 数据，以及在该特定亚组中进入 III 期临床试验的 DAA。通过搜索 clintrials.gov 来确定包括 HIV/HCV 合并感染患者在内的进入 III 期试验的 DAA。
目前可用的 DAA 可使很大一部分 HIV 合并感染患者实现 HCV 治愈。第一代 DAA 的注意事项大多已被第二代 DAA 解决。因此，正在开发的全口服方案可能接近 HIV 合并感染患者的理想 HCV 治疗方法。但是，新型 DAA 的高昂成本可能会限制其应用。
