Rockstroh Jürgen Kurt, Hardy W David
a Department of Medicine I , Bonn University Hospital , Bonn , Germany.
b German Centre for Infection Research (DZIF) , Partner Site Bonn-Cologne , Bonn , Germany.
Expert Rev Gastroenterol Hepatol. 2016 Jun;10(6):689-95. doi: 10.1586/17474124.2016.1145545. Epub 2016 Feb 12.
With the availability of all-oral, direct acting antivirals (DAAs), hepatitis C virus (HCV) therapy has been revolutionized for HIV/HCV co-infected patients. Indeed HCV cure rates are now no longer different between HCV mono and HIV/HCV co-infected persons and are both greater than 95%. Therefore, current treatment guidelines no longer separate these two groups. Indications for HCV treatment and choice of DAA combination are now the same for all HCV patients. In HIV/HCV co-infection however, drug interactions between HIV and HCV agents need be checked prior to starting HCV therapy. Finally, the higher risk of hepatic decompensation in HIV/HCV co-infected patients, including those receiving successful antiretroviral therapy, continues to make these patients a high priority group for receiving access to modern DAA combination therapy.
随着全口服直接抗病毒药物(DAAs)的出现,丙型肝炎病毒(HCV)治疗已在HIV/HCV合并感染患者中发生了变革。事实上,目前HCV单感染患者和HIV/HCV合并感染患者的HCV治愈率已无差异,且均超过95%。因此,当前的治疗指南不再区分这两组患者。现在,所有HCV患者的HCV治疗指征和DAA联合用药选择都是相同的。然而,在HIV/HCV合并感染中,开始HCV治疗前需要检查HIV和HCV药物之间的相互作用。最后,HIV/HCV合并感染患者,包括那些接受了成功抗逆转录病毒治疗的患者,发生肝失代偿的风险更高,这继续使这些患者成为接受现代DAA联合治疗的重点优先群体。