Advances in Therapy for HIV/Hepatitis C Virus–Coinfected Patients in the Liver Transplant Setting

Complications of cirrhosis due to hepatitis C virus (HCV) are increasing, and liver transplantation (LT) is the most effective treatment for those with liver decompensation or small hepatocellular carcinoma. However, for patients with human immunodeficiency virus (HIV) coinfection, barriers to LT ex...

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Bibliographic Details
Published in:Clinical infectious diseases 2015-01, Vol.60 (1), p.108-116
Main Authors: Campos-Varela, Isabel, Peters, Marion G., Terrault, Norah A.
Format: Article
Language:English
Subjects:
Antiretroviral drugs
Antiviral Agents - therapeutic use
Drug Therapy, Combination - methods
Drug Therapy, Combination - trends
Hepatitis
Hepatitis C
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Heterocyclic Compounds, 3-Ring - therapeutic use
HIV
HIV Infections - complications
HIV Infections - drug therapy
Human immunodeficiency virus
Humans
Liver
Liver Transplantation
Medical treatment
Simeprevir
Sofosbuvir
Sulfonamides - therapeutic use
Transplants & implants
Uridine Monophosphate - analogs & derivatives
Uridine Monophosphate - therapeutic use
VIRAL HEPATITIS
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Summary:Complications of cirrhosis due to hepatitis C virus (HCV) are increasing, and liver transplantation (LT) is the most effective treatment for those with liver decompensation or small hepatocellular carcinoma. However, for patients with human immunodeficiency virus (HIV) coinfection, barriers to LT exist. This is related to the poorer survival rates post-LT (55% at 5 years) and, up until this year, the limited options for treating those coinfected LT recipients with progressive recurrent HCV disease, the commonest reason for reduced survival. The newly approved antiviral therapies sofosbuvir and simeprevir, with significantly improved efficacy and markedly better safety and tolerability in HIV and transplant patients, offer the opportunity to transform the outcomes of HIV/HCV-coinfected patients with liver complications. Additional new therapies, anticipated within the year, are expected to further simplify the management of coinfected patients in the transplant setting.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciu731