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Managing Hepatitis C in Treatment-Naïve Patients with HIV Coinfection

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Transmission of HCV occurs during exposure to contaminated blood and bodily fluids, usually through sharing needles, syringes, or other drug-injection equipment. For some patients, hepatitis C is a short-term illness but for more than half of persons who become infected with HCV, it becomes a long-term, chronic infection. Chronic HCV can lead to severe illnesses such as permanent liver damage and hepatocellular carcinoma; thus, managing the disease is critical.

HIV and HCV co-infections are common. Mortality, morbidity, and hepatic decompensation rates increase with coinfection of HIV and HCV, which is why adequate and efficient treatment must be provided for both viruses.

The good news is that there are few contraindications for cotreatment of both viruses in infected patients. Since 2013, highly effective, well-tolerated curative treatments known as direct-acting antivirals (DDAs) have been available for hepatitis C; no vaccine for preventing hepatitis C, however, has been developed. In 2014 the World Health Organization guidelines began listing persons with HIV/HCV coinfection among those to be prioritized for HCV treatment.

Despite this recommendation, barriers to treatment have left a large portion of this population untreated. Barriers to treatment include race, ethnicity, socioeconomic status, sexual and gender minority statuses, and even location.

An article, published in Clinical Advisor, gives an overview of the recommendations for the management of patients with HIV/HCV coinfection in the context of the United States.

Access the overview here.