PMID- 25165545
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140828
LR  - 20211021
IS  - 2049-9361 (Print)
IS  - 2049-937X (Electronic)
IS  - 2049-9361 (Linking)
VI  - 1
IP  - 2
DP  - 2013 Apr
TI  - New agents for the treatment of hepatitis C in patients co-infected with HIV.
PG  - 71-80
LID - 10.1177/2049936113479591 [doi]
AB  - Pilot trials evaluating the efficacy and safety of the first licensed hepatitis C 
      virus (HCV) protease inhibitors (PIs), boceprevir (BOC) and telaprevir (TVR), for 
      the treatment of genotype 1 infection in HCV/HIV co-infected patients revealed 
      similar results as in HCV mono-infected patients. HCV liver disease progresses 
      more rapidly in co-infected patients, particularly with advanced 
      immunodeficiency. Therefore, HCV treatment in HIV is of great importance. 
      However, dual therapy with pegylated interferon (PegIFN) and ribavirin (RBV) has 
      been associated with lower cure rates and increased toxicities in co-infected 
      subjects, thereby limiting overall HCV therapy uptake. The availability of HCV 
      PIs opens new perspectives for HCV cure in co-infected patients, with a 70% 
      sustained virologic response (SVR) rate in HCV treatment-naive patients. Despite 
      these impressive advances, the use of the new treatment options has been low, 
      reflecting the complex issues with modern triple HCV therapy. Indeed pill burden, 
      adverse events (AEs), drug-drug interactions (DDIs) and high costs complicate HCV 
      therapy in HIV. So far, studies have shown no tolerability differences in mono- 
      and co-infected patients with the early stages of liver fibrosis. Regarding DDIs 
      between HVC PIs and antiretroviral drugs, TVR can be safely administered with 
      efavirenz (with dose adjustment of TVR), etravirine (ETR), rilpivirine, boosted 
      atazanavir (ATV/r) and raltegravir (RAL), while BOC can be safely administered 
      with ETR, RAL and potentially ATV/r for treatment-naive patients under careful 
      monitoring. Currently, the great number of HCV molecules under development is 
      promising substantially improved treatment paradigms with shorter treatment 
      durations, fewer AEs, less DDIs, once-daily administration and even 
      interferon-free regimens. The decision to treat now with the available HCV PIs or 
      defer therapy until the second generation of HCV direct acting antivirals become 
      available should be based on liver fibrosis staging and fibrosis progression 
      during follow up. More data are urgently needed regarding the efficacy of triple 
      therapy in HIV/HCV co-infected patients who previously failed PegIFN/RBV therapy 
      as well as in patients with more advanced fibrosis stages.
FAU - Munteanu, Daniela I
AU  - Munteanu DI
AD  - Department of Medicine I, Bonn University Hospital, Bonn, Germany and Adults III 
      Department, Matei Bals National Institute of Infectious Diseases, Bucharest, 
      Romania.
FAU - Rockstroh, Jurgen K
AU  - Rockstroh JK
AD  - Department of Medicine I, Bonn University Hospital, Sigmund-Freud-Str. 25, Bonn 
      53105, Germany.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Ther Adv Infect Dis
JT  - Therapeutic advances in infectious disease
JID - 101606715
PMC - PMC4040720
OTO - NOTNLM
OT  - DAA
OT  - HIV
OT  - hepatitis C
OT  - pegylated interferon
OT  - ribavirin
EDAT- 2013/04/01 00:00
MHDA- 2013/04/01 00:01
PMCR- 2013/04/01
CRDT- 2014/08/29 06:00
PHST- 2014/08/29 06:00 [entrez]
PHST- 2013/04/01 00:00 [pubmed]
PHST- 2013/04/01 00:01 [medline]
PHST- 2013/04/01 00:00 [pmc-release]
AID - 10.1177_2049936113479591 [pii]
AID - 10.1177/2049936113479591 [doi]
PST - ppublish
SO  - Ther Adv Infect Dis. 2013 Apr;1(2):71-80. doi: 10.1177/2049936113479591.