Challenges in the treatment of chronic hepatitis C in the HIV/HCV-coinfected patient

Abstract

Hepatitis C virus (HCV) and HIV are common coinfections that convey a shortened lifespan, mostly related to liver disease. Treatment against HCV in the coinfected patient is notoriously more complex and challenging. There are no optimal treatment algorithms for HIV/HCV coinfected patients as efficacy of approved anti-HCV therapies is low with relevant side effects. The use of direct-acting antivirals for anti-HCV therapy has the potential to improve therapeutic efficacy, but also increase side effects and drug–drug interactions. In spite of all of this, the most important and significant fact is that chronic hepatitis C is potentially curable, and the eradication of the HCV infection is a crucial outcome in this population. The establishment of a productive collaboration among the regulatory agencies, the medical community and the pharmaceutical industry could lead to faster access to more effective HCV therapies for the coinfected patient and eventually stop the progression of liver disease in these patients.

Keywords::

• chronic hepatitis C
• direct-acting antiviral
• drug–drug interactions
• HIV/HCV coinfection

Financial & competing interests disclosure

M Rodríguez-Torres has consulted for: Akros Pharmaceutical, Bristol–Myers Squibb, Genentech, Hoffman–La Roche, Inhibitex, Janssen R & D Ireland, Merck Sharp & Dohme Corp., Pharmasset, Santaris Pharma., Vertex Pharmaceutical Inc. M Rodriguez-Torres has received grants from: Abbott Laboratories, Akros Pharmaceutical, Anadys Pharmaceutical, Beckman Coulter, Boehringer Ingelheim, Bristol–Myers Squibb, Genentech, Gilead Pharmaceuticals, GlaxoSmithKline, Hoffman–La Roche, Human Genome Sciences, Idenix Pharmaceutical, Idera Pharmaceutical, Inhibitex, Johnson & Johnson, Merck Sharp & Dohme Corp., Mochida Pharmaceutical, Novartis, Pfizer, Pharmasset, Santaris Pharma., Scynexis, Inc., Siemens Healthcare Diagnostics, Vertex Pharmaceutical Inc. and Zymogenetics. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.