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Management of the HIV-HCV coinfected patient

See article on page 694 

Parenterally acquired infection by human immunodeficiency virus (HIV) is frequently associated with chronic hepatitis C virus (HCV) infection. Last year, the European Association for the Study of the Liver (EASL) released a consensus statement including guidelines for the management of HCV infection.1 Concerning the antiviral treatment of HCV in HIV coinfected patients, the guidelines suggested that treatment may be indicated in those patients in whom treatment has stabilised the HIV infection . Certainly, recent improvement in the antiviral treatment of each of these infections demands a reappraisal of the management of the HIV-HCV coinfected patient.

The study of Zylerberg and colleagues2 in this issue of Gut addresses one aspect of this problem—that is, the treatment of HCV during concurrent antiretroviral therapy (see page 694). The study cohort comprised 21 coinfected patients whose anti-HIV treatment included zidovudine, stavudine, and a protease inhibitor. HCV infection was treated with α interferon and ribavirin, a combination that has an established role for treatment of selected immunocompetent patients with HCV infection.3 The study concludes that combination therapy of HCV infection can be safely given …