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Hepatol Int. 2018 Nov;12(6):500-509. doi: 10.1007/s12072-018-9896-4. Epub 2018 Sep 20.

A changing paradigm: management and treatment of the HCV/HIV-co-infected patient.

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Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, Baltimore, MD, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland, Baltimore, MD, USA.
Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA.


Hepatitis C virus (HCV) treatment in HIV/HCV co-infected individuals has renewed relevance given the ongoing opioid crisis and rise of new HIV and HCV infections associated with injection drug use. Patients co-infected with HIV and HCV demonstrate increased rates of hepatic fibrosis, progression to liver failure, and liver-related mortality. HIV co-infection does not impact outcomes of current HCV treatments, and patients should be treated the same as HCV mono-infected persons, though attention to drug:drug interactions is required. In this review, we discuss the mechanisms mediating injury to the liver in HIV mono-infection and HIV/HCV co-infection, and present the landmark trials of HCV treatment in HIV-infected individuals.


Co-infection; DAA; Drug–drug interactions; HCV; HIV


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