Hepatitis C (HCV), a liver condition amenable to appropriate treatment depending on disease status, is caused by different blood-borne HCV genotypes. Approximately 130–150 million people across the globe have chronic HCV infections. In addition, millions of baby boomers— people born between 1945 and 1965 — may be unaware that they are infected with HCV. Antiviral treatment is successful in 50–90% of diagnosed cases, depending on the treatment used, but access to these resources are limited, according to the World Health Organization.
Co-infection of HIV patients with HCV (~4—5 million people worldwide), causes substantial morbidity and is associated with higher rates of all-cause, liver-related and AIDS-related deaths (1). The onset of treatments tailored to HCV and other known opportunistic infections in HIV patients has been outlined by the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America (2). For patients with an acute HCV co-infection and no spontaneous clearance, treatment should be offered using a genotype-specific regimen as for chronic HCV infection for 24 to 48 weeks. Factors favoring initiation or deferral should be taken into account before initiating HCV-genotype-specific regimens in chronically infected patients according to dosage guidelines based on concomitant anti-retroviral regimens. The national organizations also describe further considerations that should guide HCV therapy in a HIV-infected patient e.g., “HCV treatment is generally not recommended in patients with a CD4+ cell count <200 cells/μL (2).”
A complete summary of guidelines for the prevention and treatment of opportunistic infections in HIV patients can be found here.
1. von Schoen-Angerer T, Cohn J, Swan T, Piot P. UNITAID can address HCV/HIV co-infection. The Lancet. 2013;381(9867):628.
2. National Guideline Clearinghouse. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. http://www.guideline.gov/content.aspx?id=45359&search=hiv+and+opportunistic+infections. Accessed 4/23/2014.