Hepatitis C direct-acting antiviral agents: changing the paradigm of hepatitis C treatment in HIV-infected patients

J Clin Gastroenterol. 2014 Feb;48(2):106-12. doi: 10.1097/MCG.0000000000000010.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aminoisobutyric Acids
  • Antiviral Agents / therapeutic use*
  • Coinfection / complications
  • HIV Infections / complications*
  • Hepatitis C / complications*
  • Hepatitis C / drug therapy*
  • Heterocyclic Compounds, 3-Ring / therapeutic use
  • Humans
  • Interferons / therapeutic use
  • Leucine / analogs & derivatives
  • Oligopeptides / therapeutic use
  • Proline / analogs & derivatives
  • Proline / therapeutic use
  • Protease Inhibitors / therapeutic use*
  • Quinolines
  • Simeprevir
  • Sulfonamides / therapeutic use
  • Thiazoles / therapeutic use
  • Viral Nonstructural Proteins / antagonists & inhibitors*

Substances

  • Aminoisobutyric Acids
  • Antiviral Agents
  • Heterocyclic Compounds, 3-Ring
  • Oligopeptides
  • Protease Inhibitors
  • Quinolines
  • Sulfonamides
  • Thiazoles
  • Viral Nonstructural Proteins
  • telaprevir
  • N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
  • Interferons
  • faldaprevir
  • Proline
  • Simeprevir
  • NS-5 protein, hepatitis C virus
  • Leucine