HIV/HCV coinfection: Comorbidity and clinical implications

Approximately 33% of human immunodeficiency virus (HIV)-infected patients are coinfected with hepatitis C virus (HCV). Because antiretroviral therapy has become more effective and has prolonged life expectancy in HIV-infected patients, liver disease has emerged as a major cause of morbidity and mortality in those patients dually infected with HCV. HIV adversely affects all stages in the natural course of HCV infection, leading to increased viral persistence after acute infection, higher levels of viremia, and accelerated progression of cirrhosis and end-stage liver disease. The effect of HCV on the course of HIV infection is unclear, aside from the increased risk of hepatotoxicity in HIV/HCV-coinfected persons taking antiretroviral therapy. This article reviews current knowledge on the epidemiology and clinical course of HCV in HIV-infected patients.