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J Antimicrob Chemother. 2010 Jun;65(6):1079-85. doi: 10.1093/jac/dkq086. Epub 2010 Mar 23.

New directly acting antivirals for hepatitis C: potential for interaction with antiretrovirals.

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  • 1NIHR Biomedical Research Centre, Royal Liverpool & Broadgreen University Hospitals Trust, and Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK. kseden@liverpool.ac.uk

Abstract

Recent advances in the development of agents that act specifically to inhibit hepatitis C virus (HCV) are set to fundamentally change the way that patients will be treated. New directly acting anti-HCV agents such as protease and polymerase inhibitors will initially be added to standard of care with pegylated interferon-alpha and ribavirin. However, future therapy is likely to constitute combinations of agents which act at distinct stages of viral replication and have differing resistance profiles. While directly acting anti-HCV agents will undoubtedly improve treatment outcomes, the introduction of combination therapy may not be without complications in some patient groups. HIV-positive patients who are receiving antiretrovirals (ARVs) are relatively highly represented among those with HCV infection, and are at high risk of drug-drug interactions (DDIs). As combination anti-HCV treatment gradually evolves to resemble anti-HIV therapy, it is essential to consider the increased potential for DDIs in patients receiving combination anti-HCV therapy, and particularly in HCV/HIV-co-infected individuals. Therapeutic drug monitoring is likely to play a role in the clinical management of such interactions.

PMID:
20335191
[PubMed - indexed for MEDLINE]
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