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Hepatology International

, Volume 10, Issue 3, pp 424–435 | Cite as

Advances in the management of HIV/HCV coinfection

  • Mattias Mandorfer
  • Philipp Schwabl
  • Sebastian Steiner
  • Thomas Reiberger
  • Markus Peck-RadosavljevicEmail author
Review Article

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.

Keywords

Human immunodeficiency virus Hepatitis C virus Liver fibrosis Cirrhosis Portal hypertension Hepatocellular carcinoma 

Notes

Compliance with ethical standards

Conflicts of interest

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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Copyright information

© Asian Pacific Association for the Study of the Liver 2016

Authors and Affiliations

  • Mattias Mandorfer
    • 1
    • 2
  • Philipp Schwabl
    • 1
    • 2
  • Sebastian Steiner
    • 1
    • 2
  • Thomas Reiberger
    • 1
    • 2
  • Markus Peck-Radosavljevic
    • 1
    • 2
    Email author
  1. 1.Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of ViennaViennaAustria
  2. 2.Vienna HIV & Liver Study GroupViennaAustria

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