Many people with HIV also have hepatitis B (HBV) and/or hepatitis C (HCV). This is sometimes referred to as ‘co-infection’. Liver disease caused by hepatitis is a major cause of serious illness and death in people with HIV and hepatitis co-infection. Both hepatitis B and hepatitis C can be treated. There is a lot of research into new HCV treatments. Some types of HCV are harder to treat, and cure rates can be lower in people who also have HIV. Current hepatitis C treatment can also have unpleasant side-effects. However, there are many new drugs and treatment strategies in development, which may teed to better outcomes, with fewer side-effects.
A major development in HCV treatment has been the development of direct-acting antiviral drugs (DAAs) – that is, drugs that attack the hepatitis C virus itself, unlike the current standard treatment of interferon and ribavirin). These are effective as they can prevent the hepatitis C virus reproducing and quickly lead to it being eradicated from the blood and the liver.
A number of studies presented to a recent conference showed that use of combinations of DAAs or treatment with a DAA in combination with pegylated interferon and ribavirin improved treatment outcomes for HCV:
- Daclatasvir and asunaprevir cure 85% of HCV genotype 1b patients.
- Fixed-dose sofosbuvir/ledipasvir with or without ribavirin cures most patients with HCV genotype-1.
- Sofosbuvir taken before or after liver transplant reduces risk of liver cancer for patients with HCV.