Interferon-containing and interferon-free HCV therapy for HIV-infected patients

In the era of effective treatment for human immunodeficiency virus (HIV) infection, coinfection with hepatitis C virus (HCV) is an important cause of morbidity and mortality. Similar to other observations made in other HCV-infected patient populations, treatment of chronic HCV infection that results in sustained virologic response or eradication of the hepatitis infection has been strongly associated with decreased likelihood of end-stage liver disease and/or hepatocellular carcinoma and improved overall survival in HIV-infected patients. However, the effectiveness of HCV treatment has been limited due to frequent contraindications to interferon-α (INFα) and prior to the advent of HCV direct acting antivirals, relatively low rates of sustained virologic response. Since 2011, the efficacy of HCV treatment in coinfected patients has improved substantially with the addition of HCV direct-acting antivirals to INFα-based regimens. Based on these observations, there is mounting optimism that INFα-free, oral HCV treatments will further improve efficacy, and more importantly, increase access to treatment for many coinfected patients.