Liver disease is an increasingly common cause of death in patients with
human immunodeficiency virus (HIV) infection.1
Acquisition of hepatitis C virus (HCV) requires blood contact through contaminated
needles or by transfusion; sexual transmission of HCV is uncommon.2,3 HIV accelerates the progression of
HCV-related liver disease4; thus, exploring
HCV treatment in coinfected patients with HCV/HIV is a priority. To date,
experience with combination therapies using interferon plus ribavirin in coinfected
patients has been limited, and there are emerging concerns about interactions
between those drugs and HIV therapies, particularly the interaction between
ribavirin and zidovudine and between ribavirin and didanosine.5
Recent data reveal a more rapid progression to cirrhosis in individuals with
HCV/HIV coinfection who have not received protease inhibitor therapy, who
have consumed excess alcohol, and who have a low CD4 cell count.6
These observations suggest that effective HIV therapy may decrease the progression
to advanced HCV-related liver disease.
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