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Advances in the management of HIV/HCV coinfection

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Abstract

HCV coinfection has emerged as a major cause of non-AIDS-related morbidity and mortality in HIV-positive patients. As a consequence of the availability of modern combined antiretroviral therapy regimens, for optimally managed HIV/HCV-coinfected patients, the rates of liver fibrosis progression and the risk of liver-related events are increasingly similar to those of HCV-monoinfected patients. Moreover, our understanding of modulators of liver disease progression has greatly improved. In addition to immune status, endocrine, metabolic, genetic and viral factors are closely interrelated and might be important determinants of liver disease progression. In the last decade, a variety of serologic and radiographic tests for noninvasive liver disease staging have been extensively validated and are commonly used in HIV/HCV-coinfected patients. Sustained virologic response prevents end-stage liver disease, hepatocellular carcinoma, and death, with an even greater effect size in HIV-positive compared to HIV-negative patients. As interferon-free regimens achieve comparable rates of sustained virologic response in HIV-negative and HIV-positive patients, HIV/HCV-coinfected patients should from now on be referred to as a special, rather than a difficult-to-treat, population. Our comprehensive review covers all relevant aspects of HIV/HCV coinfection. Beginning with the changing epidemiology, it also provides new insights into the natural history of this condition and gives an overview on non-invasive techniques for the staging of liver disease. Furthermore, it outlines current recommendations for the treatment of acute hepatitis C and summarizes the unprecedented advances in the field of chronic hepatitis C therapy.

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References

  1. WHO. Global epidemiology: HIV/AIDS Department. 2014 (16 Nov 2015). http://www.who.int/entity/hiv/data/2014_epi_core.ppt?ua=1

  2. WHO. Fact sheet HIV/AIDS 2015 (16 Nov 2015). http://www.who.int/mediacentre/factsheets/fs360/en/

  3. Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 2014;61(1 Suppl):S45–S57

    Article  PubMed  Google Scholar 

  4. WHO. Fact sheet hepatitis C 2015 (16 Nov 2015). http://www.who.int/mediacentre/factsheets/fs164_apr2014/en/

  5. Alter MJ. Epidemiology of viral hepatitis and HIV co-infection. J Hepatol 2006;44(Supplement 1):S6–S9

    Article  PubMed  Google Scholar 

  6. Puoti M, Moioli MC, Travi G, Rossotti R. The burden of liver disease in human immunodeficiency virus-infected patients. Semin Liver Dis 2012;32(2):103–113

    Article  CAS  PubMed  Google Scholar 

  7. Boesecke C, Grint D, Soriano V, et al. Hepatitis C seroconversions in HIV infection across Europe: which regions and patient groups are affected? Liver Int 2015;35(11):2384–2391

    Article  PubMed  Google Scholar 

  8. Wandeler G, Gsponer T, Bregenzer A, et al. Hepatitis C virus infections in the Swiss HIV Cohort Study: a rapidly evolving epidemic. Clin Infect Dis 2012;55(10):1408–1416

    Article  PubMed  Google Scholar 

  9. van de Laar T, Pybus O, Bruisten S, et al. Evidence of a large, international network of HCV transmission in HIV-positive men who have sex with men. Gastroenterology 2009;136(5):1609–1617

    Article  PubMed  PubMed Central  Google Scholar 

  10. Thomson EC, Fleming VM, Main J, et al. Predicting spontaneous clearance of acute hepatitis C virus in a large cohort of HIV-1-infected men. Gut 2011;60(6):837–845

    Article  PubMed  PubMed Central  Google Scholar 

  11. Seaberg EC, Witt MD, Jacobson LP, et al. Spontaneous clearance of the hepatitis C virus among men who have sex with men. Clin Infect Dis 2015;61(9):1381–1388

    Article  PubMed  Google Scholar 

  12. Lambers FA, Prins M, Thomas X, et al. Alarming incidence of hepatitis C virus re-infection after treatment of sexually acquired acute hepatitis C virus infection in HIV-infected MSM. AIDS 2011;25(17):F21–F27

    Article  PubMed  Google Scholar 

  13. Lundgren JD, Gatell JM, Rockstroh JK, Furrer H. European AIDS Clinical Society (EACS) Guidelines Version 8.0: European AIDS Clinical Society (EACS); 2015 (16 Nov 2015). http://www.eacsociety.org/files/2015_eacsguidelines_8.0-english_revised-20151104.pdf

  14. Reiberger T. Acute hepatitis C virus infection in HIV-infected men who have sex with men: should we change our screening practice? Clin Infect Dis 2014;59(12):1694–1695

    Article  PubMed  Google Scholar 

  15. Cacoub P, Dabis F, Costagliola D, et al. Burden of HIV and hepatitis C co-infection: the changing epidemiology of hepatitis C in HIV-infected patients in France. Liver Int 2015;35(1):65–70

    Article  PubMed  Google Scholar 

  16. Benhamou Y, Bochet M, Di Martino V, et al. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The Multivirc Group. Hepatology 1999;30(4):1054–1058

    Article  CAS  PubMed  Google Scholar 

  17. Graham CS, Baden LR, Yu E, et al. Influence of human immunodeficiency virus infection on the course of hepatitis C virus infection: a meta-analysis. Clin Infect Dis 2001;33(4):562–569

    Article  CAS  PubMed  Google Scholar 

  18. Reiberger T, Ferlitsch A, Sieghart W, et al. HIV-HCV co-infected patients with low CD4+ cell nadirs are at risk for faster fibrosis progression and portal hypertension. J Viral Hepat 2010;17(6):400–409

    Article  CAS  PubMed  Google Scholar 

  19. Hull MW, Rollet K, Odueyungbo A, et al. Factors associated with discordance between absolute CD4 cell count and CD4 cell percentage in patients coinfected with HIV and hepatitis C virus. Clin Infect Dis 2012;54(12):1798–1805

    Article  CAS  PubMed  Google Scholar 

  20. Mandorfer M, Reiberger T, Payer BA, Peck-Radosavljevic M. The influence of portal pressure on the discordance between absolute CD4+ cell count and CD4+ cell percentage in HIV/hepatitis C virus-coinfected patients. Clin Infect Dis 2013;56(6):904–905

    Article  CAS  PubMed  Google Scholar 

  21. Mandorfer M, Payer BA, Schwabl P, et al. Revisiting liver disease progression in HIV/HCV-coinfected patients: the influence of vitamin D, insulin resistance, immune status, IL28B and PNPLA3. Liver Int 2015;35(3):876–885

    Article  CAS  PubMed  Google Scholar 

  22. Macias J, Berenguer J, Japon MA, et al. Fast fibrosis progression between repeated liver biopsies in patients coinfected with human immunodeficiency virus/hepatitis C virus. Hepatology 2009;50(4):1056–1063

    Article  CAS  PubMed  Google Scholar 

  23. Limketkai BN, Mehta SH, Sutcliffe CG, et al. Relationship of liver disease stage and antiviral therapy with liver-related events and death in adults coinfected with HIV/HCV. JAMA 2012;308(4):370–378

    Article  CAS  PubMed  Google Scholar 

  24. Arends JE, Lieveld FI, Boeijen LL, et al. Natural history and treatment of HCV/HIV coinfection: is it time to change paradigms? J Hepatol 2015;63(5):1254–1262

    Article  PubMed  Google Scholar 

  25. WHO. Consolidated ARV guidelines, June 2013. 2013 (16 Nov 2015). http://www.who.int/hiv/pub/guidelines/arv2013/en/

  26. Serfaty L, Forns X, Goeser T, et al. Insulin resistance and response to telaprevir plus peginterferon alpha and ribavirin in treatment-naive patients infected with HCV genotype 1. Gut 2012;61(10):1473–1480

    Article  CAS  PubMed  Google Scholar 

  27. Hull MW, Rollet K, Moodie EE, et al. Insulin resistance is associated with progression to hepatic fibrosis in a cohort of HIV/hepatitis C virus-coinfected patients. AIDS 2012;26(14):1789–1794

    Article  CAS  PubMed  Google Scholar 

  28. Abramovitch S, Dahan-Bachar L, Sharvit E, et al. Vitamin D inhibits proliferation and profibrotic marker expression in hepatic stellate cells and decreases thioacetamide-induced liver fibrosis in rats. Gut 2011;60(12):1728–1737

    Article  CAS  PubMed  Google Scholar 

  29. Ding N, Yu RT, Subramaniam N, et al. A vitamin D receptor/SMAD genomic circuit gates hepatic fibrotic response. Cell 2013;153(3):601–613

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Mandorfer M, Reiberger T, Payer BA, et al. Low vitamin D levels are associated with impaired virologic response to PEGIFN + RBV therapy in HIV-hepatitis C virus coinfected patients. AIDS 2013;27(2):227–232

    Article  CAS  PubMed  Google Scholar 

  31. Guzman-Fulgencio M, Berenguer J, Garcia-Alvarez M, et al. IL28B polymorphisms are associated with severity of liver disease in human immunodeficiency virus (HIV) patients coinfected with hepatitis C virus. J Infect 2013;66(2):170–178

    Article  PubMed  Google Scholar 

  32. Macias J, Berenguer J, Japon MA, et al. Hepatic steatosis and steatohepatitis in human immunodeficiency virus/hepatitis C virus-coinfected patients. Hepatology 2012;56(4):1261–1270

    Article  PubMed  Google Scholar 

  33. Pineda JA, Romero-Gomez M, Diaz-Garcia F, et al. HIV coinfection shortens the survival of patients with hepatitis C virus-related decompensated cirrhosis. Hepatology 2005;41(4):779–789

    Article  PubMed  Google Scholar 

  34. Reiberger T, Ferlitsch A, Payer BA, et al. Non-selective betablocker therapy decreases intestinal permeability and serum levels of LBP and IL-6 in patients with cirrhosis. J Hepatol 2013;58(5):911–921

    Article  CAS  PubMed  Google Scholar 

  35. de Oca Arjona MM, Marquez M, Soto MJ, et al. Bacterial translocation in HIV-infected patients with HCV cirrhosis: implication in hemodynamic alterations and mortality. J Acquir Immune Defic Syndr 2011;56(5):420–427

    Article  PubMed  Google Scholar 

  36. Kovari H, Ledergerber B, Peter U, et al. Association of noncirrhotic portal hypertension in HIV-infected persons and antiretroviral therapy with didanosine: a nested case-control study. Clin Infect Dis 2009;49(4):626–635

    Article  CAS  PubMed  Google Scholar 

  37. Parikh ND, Martel-Laferriere V, Kushner T, et al. Clinical factors that predict noncirrhotic portal hypertension in HIV-infected patients: a proposed diagnostic algorithm. J Infect Dis 2014;209(5):734–738

    Article  CAS  PubMed  Google Scholar 

  38. Garcia-Samaniego J, Rodriguez M, Berenguer J, et al. Hepatocellular carcinoma in HIV-infected patients with chronic hepatitis C. Am J Gastroenterol 2001;96(1):179–183

    Article  CAS  PubMed  Google Scholar 

  39. Puoti M, Bruno R, Soriano V, et al. Hepatocellular carcinoma in HIV-infected patients: epidemiological features, clinical presentation and outcome. AIDS 2004;18(17):2285–2293

    Article  PubMed  Google Scholar 

  40. Brau N, Fox RK, Xiao P, et al. Presentation and outcome of hepatocellular carcinoma in HIV-infected patients: a U.S.-Canadian multicenter study. J Hepatol 2007;47(4):527–537

    Article  PubMed  Google Scholar 

  41. Yopp AC, Subramanian M, Jain MK, et al. Presentation, treatment, and clinical outcomes of patients with hepatocellular carcinoma, with and without human immunodeficiency virus infection. Clin Gastoenterol Hepatol 2012;10(11):1284–1290

    Article  Google Scholar 

  42. Lewin M, Gelu-Simeon M, Ostos M, et al. Imaging features and prognosis of hepatocellular carcinoma in patients with cirrhosis who are coinfected with human immunodeficiency virus and hepatitis C virus. Radiology 2015;277(2):443–453

    Article  PubMed  Google Scholar 

  43. Gelu-Simeon M, Sobesky R, Haim-Boukobza S, et al. Do the epidemiology, physiological mechanisms and characteristics of hepatocellular carcinoma in HIV-infected patients justify specific screening policies? AIDS 2014;28(10):1379–1391

    Article  CAS  PubMed  Google Scholar 

  44. Omata M, Lesmana LA, Tateishi R, et al. Asian Pacific Association for the Study of the liver consensus recommendations on hepatocellular carcinoma. Hepatol Int 2010;4(2):439–474

    Article  PubMed  PubMed Central  Google Scholar 

  45. European Association For The Study of The L, European Organisation For R, Treatment of C. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012;56(4):908–943

    Article  Google Scholar 

  46. Abraldes JG, Sarlieve P, Tandon P. Measurement of portal pressure. Clin Liver Dis 2014;18(4):779–792

    Article  PubMed  Google Scholar 

  47. Perez-Latorre L, Sanchez-Conde M, Rincon D, et al. Prediction of liver complications in patients with hepatitis C virus-related cirrhosis with and without HIV coinfection: comparison of hepatic venous pressure gradient and transient elastography. Clin Infect Dis 2014;58(5):713–718

    Article  PubMed  Google Scholar 

  48. Reiberger T, Payer BA, Ferlitsch A, et al. A prospective evaluation of pulmonary, systemic and hepatic haemodynamics in HIV–HCV-coinfected patients before and after antiviral therapy with pegylated interferon and ribavirin. Antivir Ther 2012;17(7):1327–1334

    Article  CAS  PubMed  Google Scholar 

  49. Berenguer J, Zamora FX, Aldamiz-Echevarria T, et al. Comparison of the prognostic value of liver biopsy and FIB-4 index in patients coinfected with HIV and hepatitis C virus. Clin Infect Dis 2015;60(6):950–958

    Article  PubMed  Google Scholar 

  50. Macias J, Camacho A, Von Wichmann MA, et al. Liver stiffness measurement versus liver biopsy to predict survival and decompensations of cirrhosis among HIV/hepatitis C virus-coinfected patients. AIDS 2013;27(16):2541–2549

    Article  PubMed  Google Scholar 

  51. Sterling RK, Lissen E, Clumeck N, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006;43(6):1317–1325

    Article  CAS  PubMed  Google Scholar 

  52. Tural C, Tor J, Sanvisens A, et al. Accuracy of simple biochemical tests in identifying liver fibrosis in patients co-infected with human immunodeficiency virus and hepatitis C virus. Clin Gastroneterol Hepatol 2009;7(3):339–345

    Article  CAS  Google Scholar 

  53. Loko MA, Castera L, Dabis F, et al. Validation and comparison of simple noninvasive indexes for predicting liver fibrosis in HIV-HCV-coinfected patients: ANRS CO3 Aquitaine cohort. Am J Gastroenterol 2008;103(8):1973–1980

    Article  CAS  PubMed  Google Scholar 

  54. Macias J, Giron-Gonzalez JA, Gonzalez-Serrano M, et al. Prediction of liver fibrosis in human immunodeficiency virus/hepatitis C virus coinfected patients by simple non-invasive indexes. Gut 2006;55(3):409–414

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Sanchez-Conde M, Montes-Ramirez ML, Miralles P, et al. Comparison of transient elastography and liver biopsy for the assessment of liver fibrosis in HIV/hepatitis C virus-coinfected patients and correlation with noninvasive serum markers. J Viral Hepat 2010;17(4):280–286

    Article  CAS  PubMed  Google Scholar 

  56. de Ledinghen V, Douvin C, Kettaneh A, et al. Diagnosis of hepatic fibrosis and cirrhosis by transient elastography in HIV/hepatitis C virus-coinfected patients. J Acquir Immune Defic Syndr 2006;41(2):175–179

    Article  PubMed  Google Scholar 

  57. Merchante N, Rivero-Juarez A, Tellez F, et al. Liver stiffness predicts clinical outcome in human immunodeficiency virus/hepatitis C virus-coinfected patients with compensated liver cirrhosis. Hepatology 2012;56(1):228–238

    Article  PubMed  Google Scholar 

  58. Mandorfer M, Kozbial K, Freissmuth C, et al. Interferon-free regimens for chronic hepatitis C overcome the effects of portal hypertension on virologic responses. Aliment Pharmacol Ther 2015;42(6):707–718

    Article  CAS  PubMed  Google Scholar 

  59. European Association for Study of L, Asociacion Latinoamericana para el Estudio del H. EASL-ALEH Clinical Practice Guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol 2015;63(1):237–264

    Article  Google Scholar 

  60. European AIDS Treatment Network (NEAT) Acute Hepatitis C Infection Consensus Panel. Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference. AIDS 2011;25(4):399–409

    Google Scholar 

  61. Fierer DS, Dieterich DT, Mullen MP, et al. Telaprevir in the treatment of acute hepatitis C virus infection in HIV-infected men. Clin Infect Dis 2014;58(6):873–879

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Mandorfer M, Steiner S, Schwabl P, et al. Response-guided boceprevir-based triple therapy in HIV/HCV-coinfected patients: the HIVCOBOC-RGT Study. J Infect Dis 2015;211(5):729–735

    Article  PubMed  Google Scholar 

  63. Hezode C, Fontaine H, Dorival C, et al. Triple therapy in treatment-experienced patients with HCV-cirrhosis in a multicentre cohort of the French Early Access Programme (ANRS CO20-CUPIC)—NCT01514890. J Hepatol 2013;59(3):434–441

    Article  PubMed  Google Scholar 

  64. Simmons B, Saleem J, Heath K, Cooke GS, Hill A. Long-term treatment outcomes of patients infected with Hepatitis C virus: a systematic review and meta-analysis of the survival benefit of achieving a Sustained Virological Response. Clin Infect Dis 2015;61(5):730–740

    Article  PubMed  PubMed Central  Google Scholar 

  65. European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2015. J Hepatol 2015;63(1):199–236

    Article  Google Scholar 

  66. Chung RT, Davis GL, Masur H, et al. Recommendations for testing, managing, and treating hepatitis C 2015 (16 Nov 2015). http://www.hcvguidelines.org/full-report-view

  67. Mandorfer M, Payer BA, Niederecker A, et al. Therapeutic potential of and treatment with boceprevir/telaprevir-based triple-therapy in HIV/chronic hepatitis C co-infected patients in a real-world setting. AIDS Patient Care STDS 2014;28(5):221–227

    Article  PubMed  Google Scholar 

  68. Sulkowski MS, Naggie S, Lalezari J, et al. Sofosbuvir and ribavirin for hepatitis C in patients with HIV coinfection. JAMA 2014;312(4):353–361

    Article  PubMed  Google Scholar 

  69. Molina JM, Orkin C, Iser DM, et al. Sofosbuvir plus ribavirin for treatment of hepatitis C virus in patients co-infected with HIV (PHOTON-2): a multicentre, open-label, non-randomised, phase 3 study. Lancet 2015;385(9973):1098–1106

    Article  CAS  PubMed  Google Scholar 

  70. Wyles DL, Ruane PJ, Sulkowski MS, et al. Daclatasvir plus Sofosbuvir for HCV in Patients Coinfected with HIV-1. New Engl J Med 2015;373(8):714–725

    Article  CAS  PubMed  Google Scholar 

  71. Nelson DR, Cooper JN, Lalezari JP, et al. All-oral 12-week treatment with daclatasvir plus sofosbuvir in patients with hepatitis C virus genotype 3 infection: ALLY-3 phase III study. Hepatology 2015;61(4):1127–1135

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Osinusi A, Townsend K, Kohli A, et al. Virologic response following combined ledipasvir and sofosbuvir administration in patients with HCV genotype 1 and HIV co-infection. JAMA 2015;313(12):1232–1239

    Article  CAS  PubMed  Google Scholar 

  73. Naggie S, Cooper C, Saag M, et al. Ledipasvir and Sofosbuvir for HCV in patients coinfected with HIV-1. New Engl J Med 2015;373(8):705–713

    Article  CAS  PubMed  Google Scholar 

  74. Sulkowski MS, Eron JJ, Wyles D, et al. Ombitasvir, paritaprevir co-dosed with ritonavir, dasabuvir, and ribavirin for hepatitis C in patients co-infected with HIV-1: a randomized trial. JAMA 2015;313(12):1223–1231

    Article  CAS  PubMed  Google Scholar 

  75. Cohort ACH. Regression of liver stiffness after sustained hepatitis C virus (HCV) virological responses among HIV/HCV-coinfected patients. AIDS 2015;29(14):1821–1830

    Article  Google Scholar 

  76. Miro JM, Stock P, Teicher E, et al. Outcome and management of HCV/HIV coinfection pre- and post-liver transplantation. A 2015 update. J Hepatol 2015;62(3):701–711

    Article  PubMed  Google Scholar 

  77. Duclos-Vallee JC, Feray C, Sebagh M, et al. Survival and recurrence of hepatitis C after liver transplantation in patients coinfected with human immunodeficiency virus and hepatitis C virus. Hepatology 2008;47(2):407–417

    Article  CAS  PubMed  Google Scholar 

  78. Miro JM, Montejo M, Castells L, et al. Outcome of HCV/HIV-coinfected liver transplant recipients: a prospective and multicenter cohort study. Am J Transpl 2012;12(7):1866–1876

    Article  CAS  Google Scholar 

  79. Castells L, Rimola A, Manzardo C, et al. Pegylated interferon plus ribavirin in HIV-infected patients with recurrent hepatitis C after liver transplantation: a prospective cohort study. J Hepatol 2015;62(1):92–100

    Article  CAS  PubMed  Google Scholar 

  80. Antonini TM, Furlan V, Teicher E, et al. Therapy with boceprevir or telaprevir in HIV/hepatitis C virus co-infected patients to treat recurrence of hepatitis C virus infection after liver transplantation. AIDS 2015;29(1):53–58

    Article  CAS  PubMed  Google Scholar 

  81. Charlton M, Everson GT, Flamm SL, et al. Ledipasvir and Sofosbuvir plus ribavirin for treatment of HCV infection in patients with advanced liver disease. Gastroenterology 2015;149(3):649–659

    Article  CAS  PubMed  Google Scholar 

  82. Kwo PY, Mantry PS, Coakley E, et al. An interferon-free antiviral regimen for HCV after liver transplantation. New Engl J Med 2014;371(25):2375–2382

    Article  PubMed  Google Scholar 

  83. Terrault NA, Roland ME, Schiano T, et al. Outcomes of liver transplant recipients with hepatitis C and human immunodeficiency virus coinfection. Liver Transpl 2012;18(6):716–726

    Article  PubMed  PubMed Central  Google Scholar 

  84. Tricot L, Teicher E, Peytavin G, et al. Safety and efficacy of raltegravir in HIV-infected transplant patients cotreated with immunosuppressive drugs. Am J Transpl 2009;9(8):1946–1952

    Article  CAS  Google Scholar 

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Correspondence to Markus Peck-Radosavljevic.

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M.M. received honoraria for consulting from Janssen, payments for lectures from Boehringer Ingelheim, Bristol-Myers Squibb, Janssen and Roche, as well as travel support from AbbVie, Gilead, MSD and Roche. P.S. received payments for lectures from Roche and travel support from Janssen and Roche. S.S. has nothing to disclose. T.R. received payments for lectures from Roche, as well as travel support from Gilead, MSD and Roche. M.P.-R. received grants from Gilead, MSD and Roche, honoraria for board membership and consulting from AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead, Janssen and MSD, as well as payments for lectures from AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead, Janssen, MSD and Roche.

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Mandorfer, M., Schwabl, P., Steiner, S. et al. Advances in the management of HIV/HCV coinfection. Hepatol Int 10, 424–435 (2016). https://doi.org/10.1007/s12072-015-9691-4

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