HCV and HIV co-infection: who to treat?
As therapy of HIV patients with HAART has resulted in long-term survival, the major burden of "disease" is becoming end-stage liver disease secondary to HCV infection with rapidly progressive fibrosis and cirrhosis. We are increasingly being asked to advise on this group of patients, however, the literature is cautious about treatment and response rates. Who do we treat? What is the response rate to achieve HCV clearance? What are the risks of potential HIV decompensation? Interferon monotherapy (incl PEG-Inf) or combination therapy?
Should the guidelines include special interest groups such as HCV/HIV and HCV/HBV co-infections?
Dr Frank Weilert Gastroenterolist Waikato Hospital Hamilton New Zealand