HIV and hepatitis C co-infection: acute HCV therapyBoesecke, Christopha; Vogel, MartinbCurrent Opinion in HIV and AIDS: November 2011 - Volume 6 - Issue 6 - p 459–464 doi: 10.1097/COH.0b013e32834b87de HIV and hepatitis C coinfection: Edited by Jürgen Rockstroh and Gail Matthews Abstract Author Information Purpose of review Almost 10 years ago clinicians started to note first cases of an outbreak of acute hepatitis C (AHC) infections among HIV-positive men who have sex with men (MSM) in Europe, soon followed by similar reports from the USA and Australia. To date, no randomized controlled treatment trials in AHC co-infection have been conducted. However, to give clinicians guidance in best clinical management of these patients expert consensus recommendations based upon published data from uncontrolled clinical and cohort studies have recently been published. Recent findings The early course of hepatitis C virus (HCV) RNA in the first 4 weeks after diagnosis is considered to be a helpful predictor of spontaneous clearance of AHC in HIV-infected individuals. Additionally, single-nucleotide polymorphisms near the IL28B gene further augment chances of spontaneous clearance. Pegylated interferon in combination with weight-adapted ribavirin is still recommended as treatment of choice for all HCV genotypes. For patients developing a rapid virological response (RVR), defined as a negative HCV-RNA in an ultrasensitive assay, treatment duration of 24 weeks is recommended. If antiviral therapy was initiated within 24 weeks after diagnosis high sustained virological response (SVR) rates of 60–80% have been observed. Summary Prevention and screening efforts along with early anti-HCV therapy have to be intensified to allow control of viral dissemination as the current epidemic of AHC particularly among MSM is still ongoing. Concise recommendations for best clinical management of AHC in HIV infection on the basis of published observational data have been published. aDepartment of Internal Medicine I bDepartment of Internal Medicine III, University of Bonn, Bonn, Germany Correspondence to Dr Christoph Boesecke, Department of Medicine I, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, GermanyTel: +49 228 287 16558; fax: +49 228 287 15034; e-mail: email@example.com © 2011 Lippincott Williams & Wilkins, Inc.