Resultados en práctica clínica real del tratamiento de la hepatitis C con nuevos antivirales de acción directa en pacientes con coinfección VIH/VHC

Résumé

Hepatitis C virus (HCV) infection is one of the main comorbidities in patients infected by human immunodeficiency virus (HIV) in Spain. Without treatment, these patients develop cirrhosis and associated complications, especially in the era in which highly effective antiretroviral therapy has prevented complications from acquired immunodeficiency syndrome and prolonged survival of HIV-infected patients.Eradication of chronic HCV infection prevents progression of liver disease and associated morbidity and mortality in HCV monoinfected and HIV/HCV coinfected patients.Until 2014, the treatment of chronic HCV infection consisted of interferon (IFN) -based regimens. This treatment had limited effectiveness and high toxicity, and in HIV-infected patients its effectiveness was even lower.The introduction of direct-acting antivirals (DAAs) represents a therapeutic advance in the treatment of the HIV/HCV coinfected patient, developing interferon-free treatments with high efficacy and safety in clinical trials. In these clinical trials, although there were some specifically designed in the coinfected population, the number of coinfected patients has been limited and with highly selected patients, so it is difficult to extrapolate the results to the general population with HIV/HCV coinfection...