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Antiretroviral therapy in HIV/HCV co-infection Italian consensus workshop

Nasta, Paola and Cattelan, Anna Maria and Maida, Ivana Rita and Gatti, Francesca and Chiari, Erika and Puoti, Massimo and Carosi, Giampiero (2013) Antiretroviral therapy in HIV/HCV co-infection Italian consensus workshop. Advances in infectious diseases, Vol. 3 (2), p. 105-114. ISSN 2164-2648. eISSN 2164-2656. Article.

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DOI: 10.4236/aid.2013.32017

Abstract

About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infection also exposes patients to a higher risk of progression to AIDS, a faster evolution towards cirrhosis, more frequent drug toxicity, and lower tolerance for antiretroviral therapy. Moreover, HCV infection can play a part in increasing immune system depression; neurological, cognitive and renal damage; and bone fragility. Hence an optimal antiretroviral regimen needs to be chosen for co-administration with anti-HCV therapy and timed appropriately to improve the prognosis of co-infected HIV/HCV patients. Unfortunately, however, data on the safety and efficacy of antiretroviral drugs in these patients is scarce, as are studies of pharmacokinetics in patients with advanced liver impairment. Furthermore, restoring adequate immune constitution seems not to slow the progression of liver disease, and the metabolic and hepatic toxicity of some antiretroviral drugs can even contribute to inflammatory and fibrogenic processes. It is therefore essential that HIV/HCV co-infected patients receive only medications capable of ensuring the best immune recovery but possessing the lowest potential to trigger immune reconstitution syndrome or hepatic and metabolic damage.

Item Type:Article
ID Code:9635
Status:Published
Refereed:Yes
Uncontrolled Keywords:ART, HIV/HCV, co-infection, liver toxicity
Subjects:Area 06 - Scienze mediche > MED/17 Malattie infettive
Divisions:001 Università di Sassari > 03 Istituti > Malattie infettive e parassitarie
001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Clinica e Sperimentale
Publisher:Scientific Research Publishing
ISSN:2164-2648
eISSN:2164-2656
Copyright Holders:© Paola Nasta et al., © SciRes.
Deposited On:21 Feb 2014 09:33

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