Persons living with an HCV-HIV<unk>  are at higher risk for certain adverse medical outcomes, such as accelerated hepatic fibrosis, hepatic decompensation, and immune dysregulation. Due to higher mortality rates in co-infected individuals as a result of accelerated liver disease - in comparison to individuals with<unk>  mono-infection - the treatment objective would be to primarily target the HCV infection in these individuals. In individuals living with<unk> , anti-retroviral therapy (ART) has been shown to preserve immune function, reduce the effects of<unk> -related inflammation, and delay hepatic disease. Therefore, treatment plans for individuals with<unk> /HCV<unk>  include: an initial ART regimen (as recommended for<unk>  mono-infected individuals); simultaneous HCV treatment involving oral direct-acting antivirals (DAA); and special consideration given to potential for severe drug-drug interactions between the selected medication regimens. When initiating DAA therapy, the individual is typically assessed for ART-naivety. It is recommended that the individual, if not previously already on ART for<unk>  maintenance, initiate ART 4–6 weeks prior to DAA administration in order to adequately adjust to regimen and provide a greater foundation for efficacious response to HCV treatment. HCV Treatment Options: The overall goal of HCV DAA therapy is to create a Sustained Virological Response for 12 consecutive weeks (SVR12) to ensure the<unk>  C virus is not detected in the blood. In clinical trials, the use of the following DAA combinations have shown similar efficacy rates (by achieving SVR12) in individuals with<unk> /HCV<unk>  as those with HCV mono-infection: Elbasvir/Grazoprevir * The Phase 3, open-label, single-arm C-EDGE<unk>  Study showed that 96% (210 out of 218) of individuals with HCV genotype 1,4, or 6 and<unk> <unk>  were able to attain SVR12 at the end of the 12-week course of treatment. Glecaprevir/Pibrentasvir * The Phase 3, multi-center EXPEDITION-2 Study showed that an 8-week treatment in<unk> /HCV co-infected individuals with HCV genotype 1, 2, 3, 4, or 6 without cirrhosis provided an overall SVR12 of 100% (136 out of 136 individuals), while a 12-week treatment in<unk> /HCV co-infected individuals with HCV genotype 1, 2, 3, 4, or 6 with compensated cirrhosis provided an overall SVR12 of 93% (14 out of 15 individuals). Ledipasvir/Sofosbuvir * The multi-center, open-label, ION-4 Study showed that a 12-week course of treatment provided an overall SVR12 of 96% (321 out of 335 individuals) in individuals co-infected with<unk>  and HCV genotype 1 or 4. Due to limited clinical safety data, the following DAA combinations, while available, are not considered as first-line therapies: Sofosbuvir/Velpatasvir Sofosbuvir/Velpatasvir/Voxilaprevir Barriers to care Barriers to care exist when discussing therapeutic options for HCV/HIV co-infected individuals. For example, other co-morbidities such as severe hepatic decompensation, cardiac disease, and renal disorders contribute to treatment barriers since these individuals would not be eligible for anti-retroviral therapy. Individuals with continued alcohol/drug/substance abuse and those that exhibit depressive symptoms along with suicidal ideations are also subject to ineligible status for HCV treatment in HCV/HIV co-infected persons.
Hepatitis C and HIV coinfection
HIV superinfection
Tuberculosis in relation to HIV
Epstein–Barr virus infection
HPV-positive oropharyngeal cancer
Latent autoimmune diabetes in adults
Smoking in South Korea
History of coronavirus