A changing paradigm: management and treatment of the HCV/HIV-co-infected patient

Hepatol Int. 2018 Nov;12(6):500-509. doi: 10.1007/s12072-018-9896-4. Epub 2018 Sep 20.


Hepatitis C virus (HCV) treatment in HIV/HCV co-infected individuals has renewed relevance given the ongoing opioid crisis and rise of new HIV and HCV infections associated with injection drug use. Patients co-infected with HIV and HCV demonstrate increased rates of hepatic fibrosis, progression to liver failure, and liver-related mortality. HIV co-infection does not impact outcomes of current HCV treatments, and patients should be treated the same as HCV mono-infected persons, though attention to drug:drug interactions is required. In this review, we discuss the mechanisms mediating injury to the liver in HIV mono-infection and HIV/HCV co-infection, and present the landmark trials of HCV treatment in HIV-infected individuals.

Keywords: Co-infection; DAA; Drug–drug interactions; HCV; HIV.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Coinfection / complications
  • Coinfection / drug therapy*
  • Drug Interactions
  • Drug Therapy, Combination
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • Hepatic Stellate Cells / virology
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Hepatitis C / metabolism
  • Hepatocytes / virology
  • Humans
  • Liver Cirrhosis / virology*


  • Antiviral Agents