Challenges and opportunities for hepatitis C drug development in HIV-hepatitis C virus-co-infected patients.

Abstract

The approval of the first direct-acting antivirals (DAAs) against the hepatitis C virus (HCV) has been eagerly expected for treating chronic hepatitis C in HIV individuals given that progression to cirrhosis and end-stage liver disease occurs faster in the co-infected population. The appropriate and judicious use of DAAs may provide cure to a large number of HIV-HCV patients. On the contrary, the widespread use of DAAs will occasionally be off-label or under unsatisfactory medical conditions, which may result in undesirable toxicities, drug interactions or selection of drug resistance in HCV. As a result of using first-generation DAAs in HIV-HCV-co-infected patients, a growing proportion of the remaining hepatitis C individuals will be those harboring non-HCV 1 genotypes or drug-resistant HCV variants. Over time, the largest reservoir of HCV genotype 1 patients will accumulate in resource-poor nations where access to hepatitis C therapy has been elusive and HIV treatment remains the primary health issue for the co-infected population.

• Authors: Vincent Soriano, Kenneth E Sherman, Juergen Rockstroh, Douglas Dieterich, David Back, Mark Sulkowski, Marion Peters
• Journal: AIDS (London, England) (AIDS) Vol. 25 Issue 18 Pg. 2197-208 (Nov 28 2011) ISSN: 1473-5571 [Electronic] England
• PMID: 21866039 (Publication Type: Editorial, Review)
• Copyright: 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chemical References

• Anti-HIV Agents
• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• Oligopeptides
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• telaprevir
• N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
• Proline
• peginterferon alfa-2b

Topics

• Anti-HIV Agents
• Antiviral Agents (administration & dosage, pharmacokinetics, therapeutic use)
• Clinical Trials as Topic
• Coinfection (drug therapy)
• Drug Resistance, Viral
• HIV Infections (complications)
• Hepacivirus (genetics)
• Hepatitis C, Chronic (complications, drug therapy)
• Humans
• Interferon alpha-2
• Interferon-alpha (administration & dosage)
• Liver Cirrhosis (virology)
• Oligopeptides (administration & dosage, therapeutic use)
• Polyethylene Glycols (administration & dosage)
• Proline (administration & dosage, analogs & derivatives, therapeutic use)
• Recombinant Proteins (administration & dosage)
• Ribavirin (administration & dosage)