Care of patients coinfected with HIV and hepatitis C virus: 2007 updated recommendations from the HCV-HIV International Panel

Chronic hepatitis C (HCV) infection is currently oneof the most clinically relevant comorbidities in theHIV population; overall, it affects one third of HIV-positive individuals [1]. Progression to end-stage liverdisease occurs faster in coinfected patients [2–4] anddecompensated cirrhosis is one of the main causes ofhospitalization and death in this population [5–8].However, the risk of hepatotoxicity using antiretroviraldrugs is increased in subjects with underlying HCVinfection [9,10]. Therefore, the optimal managementof chronic HCV in HIV-positive patients is currentlyapriority.Several guidelines for caring for HCV infection in HIV-positive individuals have been released [11–15]. Becausenew and relevant information has recently appeared, it isconvenient to update them. Eleven areas have beenidentified in which new recommendations are particu-larly needed:management of patients with persistently normalaminotransferasesliver fibrosis assessment: when and howpredictors of response to anti-HCV therapy in coinfectedpatientsoptimal dosages of pegylated interferon (pegIFN) andribavirin (RBV)optimal duration of anti-HCV therapytreatment of non-responders and/or relapserscare of patients with end-stage liver diseasetreatment of acute HCV infection in HIV-infectedindividualsmanagement of patients with multiple hepatitis virusesinteractions between HCV medications and antiretroviraldrugshepatotoxicity of antiretroviral drugs.