Overcoming challenges in the management of HCV/HIV coinfection

The clinical impact of hepatitis C virus (HCV) and HIV coinfection has become more pronounced in the era of highly active antiretroviral therapy. Progression of HCV infection in coinfected patients is rapid, resulting in increased morbidity and mortality due to liver disease. Hepatotoxicity of antiretrovirals is common and presents significant changes in disease management. The current standard of care for treatment of HCV infection is the combined use of pegylated interferon alfa and ribavirin given for prolonged periods. In patients with coinfection, special considerations are required for both the use of these medications and management of potential toxicities.