Can Highly Active Antiretroviral Therapy Slow Down the Progression of Hepatitis C Disease in Patients with HIV Coinfection?

Abstract

Evaluation of: Pineda JA, Garcia-Garcia JA, Aguilar-Guisado M et al.: Clinical progression of hepatitis C virus-related chronic liver disease in human immunodeficiency virus-infected patients undergoing highly active antiretroviral therapy. Hepatology 46, 622–630 (2007). The natural history of liver disease in HIV/HCV coinfected subjects under highly active antiretroviral therapy still remains unknown. Although cohort studies have shown a decrease in liver fibrosis progression and liver disease-associated mortality under highly active antiretroviral therapy, this is contrasted by exceeding morbidity and mortality due to long-term adverse effects of antiviral therapy on the liver. The current study by Pineda and colleagues demonstrates that end-stage liver disease indeed is the primary cause of death in HIV/HCV coinfected patients under highly active antiretroviral therapy. Moreover, they demonstrate that an adequate response to HIV therapy is a factor associated with a better outcome of chronic liver disease.