Authors: Bryan Tolentino (Icahn School of Medicine at Mount Sinai, NY, USA)
Take a look behind the scenes of a recent Future Virology review entitled ‘An update on the management of hepatitis C virus and human immunodeficiency virus coinfection’, as we ask the authors about their inspiration and the future of this field.
What inspired you to write this piece?
I was inspired by my background on infectious diseases and HIV and my interest in hepatitis C treatment. We currently have multiple treatment options that are impacting thousands of patients; a good portion of them being treated in non-specialty settings. Nowadays HIV is being managed more and more by primary care providers and we hope that this article serves as a reference for those who would also be managing hepatitis C virus (HCV) and the coinfected.
Why is the interaction between HCV and HIV significant?
Because there is a significant amount of HIV/HCV coinfected patients and both viruses interact with each other by potentiating the damage to organ systems, especially the liver. It has been demonstrated that HIV can accelerate the process of cirrhosis when compared with monoinfected patients.
How does coinfection affect treatment?
The interaction of HIV and HCV is significant both in their pathogenesis but also in the treatment options given that the mechanism of action of the drugs we currently use can be similar (e.g., protease inhibitors). Furthermore, boosted HIV regimens can have significant drug interactions and often patients need to be switched off these regimens before being able to start HCV therapy.
What work are you hoping to do/ what do you think needs to be done in this area?
I definitely think that we need more studies looking at the long-term outcomes and benefits of HCV treatment in coinfected patients. We are seeing a decrease in the rate of progression to cirrhosis but there are many other benefits of HCV cure that could be looked at.
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