HIV and hepatitis C co-infection: the role of HAART in HIV/hepatitis C virus managementJones, Michelle; Núñez, MarinaCurrent Opinion in HIV and AIDS: November 2011 - Volume 6 - Issue 6 - p 546–552 doi: 10.1097/COH.0b013e32834bcbd9 HIV and hepatitis C coinfection: Edited by Jürgen Rockstroh and Gail Matthews Abstract Author Information Purpose of review Highly active antiretroviral therapy (HAART)-related hepatotoxicity, a relevant side effect in HIV/hepatitis C virus (HCV) co-infected patients, has evolved over time. Antiretroviral therapy might have a positive effect on the liver of HIV/HCV co-infected patients, but data are conflicting. Recent findings HIV treatments have evolved and we have currently a drug armamentarium with a good liver safety profile. Most of the current first-line HAART regimens recommended by guidelines fit well to HIV/HCV co-infected patients. There are now multiple retrospective studies that suggest a possible benefit of HIV control and protection of CD4 cell counts to the liver of HIV/HCV co-infected patients. However, data are conflicting at times. This factor along with the methodological limitations of these studies prevent us from drawing definitive conclusions. Even assuming a positive effect, HAART does not appear to fully correct the adverse effect of HIV infection on HCV-related outcomes. In the era of HCV direct antiviral agents, the timing of HIV and HCV therapies has to be individualized in HIV/HCV co-infected patients given the variety of scenarios. Summary With current HIV drug armamentarium it is possible to construct HAART regimens with optimal liver safety profile for HCV co-infected patients. The possible positive effect of HAART on the HCV-infected liver should not distract from the main intervention, which is HCV eradication with specific treatment. Department of Internal Medicine, Section on Infectious Diseases, Wake Forest University Baptist Medical Center, Winston Salem, North Carolina, USA Correspondence to Marina Núñez, MD, PhD, Department of Internal Medicine, Section on Infectious Diseases, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston Salem, NC 27157, USATel: +1 336 7164512; e-mail: firstname.lastname@example.org © 2011 Lippincott Williams & Wilkins, Inc.