Hepatitis C Virus in the Setting of HIV or Hepatitis B Virus Coinfection

Richard K. Sterling; Mark S. Sulkowski

doi:10.1055/s-2004-832930

Seminars in Liver Disease, Inhaltsverzeichnis

Semin Liver Dis 2004; 24: 61-68
DOI: 10.1055/s-2004-832930

Hepatitis C Virus in the Setting of HIV or Hepatitis B Virus Coinfection

Richard K. Sterling¹ , Mark S. Sulkowski²

¹Virginia Commonwealth University Health System/Medical College of Virginia, Richmond, Virginia
²Johns Hopkins University School of Medicine, Baltimore, Maryland

Abstract

Because of shared routes of transmission, coinfection with hepatitis C virus (HCV) or hepatitis B virus (HBV), or both, is common among HIV-infected persons, affecting approximately 15 to 30% and 10 to 15% of patients, respectively. Advances in antiretroviral therapy have improved the life expectancy of patients infected with HIV, and, as a consequence, HCV-related liver disease has emerged as a significant comorbid disease among such patients. Concurrent HIV infection may be associated with higher serum HCV RNA levels, accelerated progression of hepatic fibrosis, increased risk of end-stage liver disease, hepatocellular carcinoma and death among persons coinfected with hepatitis C. Similarly, coinfection with HCV and HBV may lead to more severe liver disease and greater risk of hepatocellular carcinoma (HCC) than does HCV infection alone. Although definitive randomized controlled trials are not yet completed, current guidelines recommend the use of pegylated interferon alfa plus ribavirin for the treatment of chronic HCV in eligible HIV-infected persons. Conversely, the optimal treatment of chronic HCV in persons with chronic HBV infection has not been defined but may include pegylated interferon alfa plus ribavirin, with or without additional antiviral agents, such as lamivudine or adefovir, or both.

KEYWORDS

HCV-HIV - HCV-HBV coinfection

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Richard K SterlingM.D.

Virginia Commonwealth University Health System/Medical College of Virginia

Box 980341, 1200 East Broad Street, Room 1492

Richmond, VA 23298

eMail: rksterli@hsc.vcu.edu