Hepatitis C virus infection in HIV-infected patients
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- Sulkowski, M.S. Current Hepatitis Reports (2002) 1: 16. doi:10.1007/s11901-002-0004-8
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Due to shared routes of acquisition, hepatitis C virus (HCV) infection is common in HIV-infected persons. Because the lives of HIV-infected persons have been extended by the use of effective antiretroviral therapies, HCV-related morbidity and mortality have emerged as major health problems. Coinfection with HIV appears to adversely affect all stages of hepatitis C infection, leading to increased viral persistence following acute infection, higher levels of viremia, and accelerated progression of HCVrelated liver disease. In addition, hepatitis C may impact the course and management of HIV infection, increasing the incidence of hepatotoxicity caused by antiretroviral medications. The medical management of hepatitis C in HIV-infected persons remains complex, due largely to the paucity of published clinical trials, potential drug-drug interactions, and the presence of significant comorbid conditions. Nonetheless, in light of an accelerated HCV disease course, the National Institutes of Health Consensus Development Conference Statement (2002) recommends that HIV-infected patients be considered for HCV treatment. Further research is urgently needed on the management of hepatitis C in HIV-infected patients.