Hepatitis C-HIV coinfection: Current and future therapy

Coinfection with hepatitis C in HIV-infected patients has been reported in 15-70% of patients depending on the mode of acquisition of both viruses. As recent advances in HIV-directed antiviral therapy have markedly delayed HIV progression and mortality, the incidence of complications arising from hepatitis C-associated liver disease in coinfected patients is increasing exponentially. The interaction of HIV and hepatitis C is complex. It is clear that HIV infection negatively affects the natural history of hepatitis C, while HIV-directed therapy may enhance immunologic response and exacerbate hepatocellular injury induced by hepatitis C via immune reconstitution. In this review, the pathobiology, inter-relation of hepatitis C and HIV infection in coinfected patients as well as present and future treatment in this unique patient population are discussed.