Chronic hepatitis C virus (HCV) infection affects over three million individuals in the U.S., with an estimated 80,000 HCV-related deaths per year. Liver disease has emerged as the leading cause of non-AIDS-related death among HIV-infected individuals, among whom the health impacts of HCV infection are more severe.
Our researchers have examined the association of HIV/HCV coinfection with HIV-associated outcomes, finding slower CD4 cell restoration in the first year after initiation of antiretroviral therapy and an overall higher risk of mortality compared with HIV-monoinfected individuals. These findings emphasize the need for aggressive treatment of HCV infection in HIV/HCV-coinfected individuals. The recent emergence of highly effective and costly HCV therapies has revolutionized HCV treatment, particularly for the HIV/HCV-coinfected population who are at the highest priority for treatment with the newest direct-acting antivirals. Clinical trials of new HCV treatments have demonstrated similar cure rates by HIV status.
As these therapies are disseminated and the population of previously HCV-infected individuals grows, researchers are beginning to investigate short- and long-term hepatic and extrahepatic outcomes after HCV cure, with a focus on the role of HIV infection in these outcomes. Researchers have also reported on incident cases of sexually transmitted HCV infection among HIV-uninfected men who have sex with men using preexposure prophylaxis to prevent HIV infection, suggesting that this high-risk group may benefit from ongoing screening for HCV infection.