HCV and HIV co-infection: mechanisms and management

Patients co-infected with HCV and HIV are at increased risk of accelerated disease progression, resulting in higher rates of liver decompensation and death compared with patients monoinfected with HCVHIV accelerates HCV-related fibrosis progression through multiple mechanismsHIV suppression seems to reduce fibrosis progression and decrease rates of hepatic decompensation among co-infected patientsSuccessful HCV therapy is associated with a halting of fibrosis progression and decreased complications from end-stage liver disease, but historical rates of sustained virologic response have been significantly lower among co-infected patients than those for chronic HCV monoinfectionPromising data exist for all-oral direct-acting antiviral agents suggesting improved efficacy and tolerability, which supports their use in co-infection