Therapy Insight: management of hepatitis C in patients coinfected with HIV

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Abstract
Coinfection with HCV and HIV is common and an increasingly important public health problem. Management of hepatitis C in HIV-infected patients is complicated by immune suppression, potential drug interactions and toxicities, and the relative paucity of health-care providers with expertise in the management of both diseases. Data now support the safety, tolerability and efficacy of hepatitis C treatment with peginterferon plus ribavirin in HIV-infected patients. Infection with HCV is common in HIV-infected patients and is an increasingly important public health problem. The medical management of hepatitis C in HIV-infected patients is complicated by immune suppression, potential drug interactions and toxicities, and the relative paucity of health-care providers with expertise in the management of both diseases. Nonetheless, there are now data to support the safety, tolerability and efficacy of hepatitis C treatment with peginterferon plus ribavirin in HIV-infected patients, and the impetus to treat these patients is, therefore, strong. Although the standard of care for the treatment of hepatitis C in HIV-infected patients has been more clearly defined, the delivery of care for hepatitis C remains inconsistent in many settings. The development and implementation of single-center multidisciplinary programs that combine the expertise of HIV specialists, hepatologists, gastroenterologists, psychiatrists, and addiction specialists, are needed to improve hepatitis C treatment outcomes in HIV-infected patients. This review considers the management of HCV infection in HIV-infected patients.