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Hepatitis C Direct-acting Antiviral Agents: Changing the Paradigm of Hepatitis C Treatment in HIV-infected Patients

Martel-Laferrière, Valérie MD; Bichoupan, Kian MS; Dieterich, Douglas T. MD

Journal of Clinical Gastroenterology: February 2014 - Volume 48 - Issue 2 - p 106–112
doi: 10.1097/MCG.0000000000000010
Clinical Reviews

Hepatitis C virus (HCV)–related liver disease is a major source of mortality in HIV-infected patients. Approximately one third of all patients with HIV are co-infected with HCV. Patients co-infected with HIV/HCV have shown lower rates of sustained virologic response with pegylated-interferon and weight-based ribavirin as well as more rapid progression of fibrosis than those with HCV mono-infection. Several direct-acting antiviral agents (DAAs), developed originally for HCV mono-infection, are being reevaluated for HIV/HCV co-infection. In addition, entirely new DAAs are being developed, including, interferon-free regimens with fewer side effects, allowing novel treatment opportunities for difficult-to-treat patients. In order for HCV DAAs to be successfully used in the HIV/HCV co-infected population several hurdles must be overcome, including adverse event management and drug-drug interactions. The aim of this review is to discuss the results of trials for new HCV therapies being developed for HIV/HCV co-infected patients and the impact of interferon-free regimens on treatment in the future.

Icahn School of Medicine at Mount Sinai, New York, NY

V.M.-L. was funded by the 2012 Grant of the CHUM Foundation.

D.T.D. serves as a paid lecturer, consultant, and is a member on scientific advisory boards of companies that either develop or assess medicines used for the treatment of viral hepatitis. These companies include Gilead Sciences, Boehringer Ingelheim, Novartis, Vertex Pharmaceuticals, Achillion, Tibotec, Idenix, Merck, Kadmon, Bayer Healthcare, Roche/Genentech, and Bristol-Myers Squibb. The remaining authors declare that they have nothing to disclose.

Reprints: Douglas T. Dieterich, MD, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 (e-mail:

© 2014 by Lippincott Williams & Wilkins