Due to shared routes of transmission, acute and
chronic infection with hepatitis C virus is common among persons living with
HIV infection in many regions of the world. In the era of effective antiretroviral
therapy, acute HCV
infection has been increasingly recognized in HIV-infected persons, particularly men who have sex with men, and
liver disease, including
hepatocellular carcinoma, has emerged as a leading cause of morbidity and mortality in those with chronic HCV
infection, particularly older adults with long-standing
coinfection. Over the past decade, the foundation for the management of acute and chronic HCV
infection has been
interferon alfa. However, due the high burden of treatment-related side effects and low likelihood of sustained virologic response, the impact of treatment with peginterferon/
ribavirin on the burden of HCV disease in has been limited. However, the anticipated availability of safe, tolerable and highly efficacious
interferon-free, oral HCV direct-acting
antiviral combination
therapies promise to dramatically change the management of acute and chronic HCV
infection in HIV-infected persons. Preliminary data from studies of such oral DAA regimens in HIV/HCV coinfected patients suggest that
coinfection with HIV will not impair HCV cure with these regimens. Indeed, in the coming era of high effective oral HCV DAA treatments, the only special feature concerning treatment of acute and chronic HCV
infection in HIV-infected patients may be drug interactions between the antiretroviral drugs for
HIV infection and direct-acting
antiviral drugs for HCV
infection.