Treatment of hepatitis C in HIV patients in the new era of direct-acting antivirals

Chronic hepatitis C virus (HCV) infection occurs globally in 20 % of HIV-seropositive patients. In coinfected individuals, HCV-related liver disease is a leading cause of morbidity and mortality. The advent of new direct-acting antivirals (DAA) has been particularly awaited for this population, in whom treatment with peginterferon plus ribavirin depicts limited efficacy and poor tolerability. However, pharmacologic interactions, drug resistance, medication adherence and pricing are major challenges using DAA in HIV/HCVcoinfected patients. Moreover, if the benefit of new antiviral therapies for hepatitis C wants to be recognized at population scale, underdiagnosis and access to particularly difficult to reach populations must be ensured. © Springer Science+Business Media New York 2013.