Meissner Eric G
Division of Infectious Diseases, Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA.
Curr Opin Gastroenterol. 2017 May;33(3):120-127. doi: 10.1097/MOG.0000000000000347.
Availability of direct acting antivirals (DAAs) that demonstrate remarkable clinical efficacy and safety has revolutionized the ability to treat chronic infection with hepatitis C virus (HCV). An equal measure of clinical success has now been achieved in persons coinfected with HCV and the HIV, a historically harder to cure cohort with interferon-based therapy. Global goals include identifying all HIV-HCV-infected persons, gaining access to DAA therapy, preventing de novo and reinfection, and managing the sequelae of chronic infection. This review will discuss advances in the field of HIV-HCV coinfection reported during the last 18 months, and will suggest areas for future investigation.
An expanding body of literature has enhanced our understanding of the clinical and epidemiologic issues surrounding HIV-HCV coinfection. DAA therapy for HCV is highly efficacious in HIV-HCV-coinfected persons if drug-drug interactions are appropriately considered.
Eradicating HCV infection in persons with HIV coinfection can be achieved safely and effectively with available DAAs. Economic and social approaches to enable access and delivery of curative HCV therapy to HIV-infected persons require continued research and resource allocation.
直接作用抗病毒药物(DAA)的出现,其展现出卓越的临床疗效和安全性,彻底改变了丙型肝炎病毒(HCV)慢性感染的治疗能力。在HCV与HIV合并感染患者中也取得了同样程度的临床成功,这一群体在历史上采用基于干扰素的疗法更难治愈。全球目标包括识别所有HIV-HCV合并感染的患者,使他们能够接受DAA治疗,预防新发感染和再感染,并管理慢性感染的后遗症。本综述将讨论过去18个月中报道的HIV-HCV合并感染领域的进展,并提出未来研究的方向。
越来越多的文献增进了我们对围绕HIV-HCV合并感染的临床和流行病学问题的理解。如果适当考虑药物相互作用,用于HCV的DAA疗法在HIV-HCV合并感染患者中具有高度疗效。
使用现有的DAA可以安全有效地根除HIV合并感染患者中的HCV感染。实现向HIV感染者提供可治愈的HCV治疗的经济和社会方法需要持续的研究和资源分配。