Chronic Hepatitis C infection is now the leading cause of death after AIDS-related complications in HIV infected individuals in the United States. HIV coinfection exacerbates Hepatitis C virus disease leading to more rapid progression to cirrhosis, liver cancer and mortality. This is felt to be due to impaired T-cell immune responses to Hepatitis C in HIV positive patients.
Until now, the standard of care led to cure rates in only 20 percent of coinfected patients. However, the approval last year of two new agents called protease inhibitors are showing a great deal of promise in studies currently under way with cure rates possibly reaching 80-90 percent in some studies.
It is now standard of care for all HIV patients to be screened for Hepatitits C coinfection with the hope that therapy will cause a marked improvement in morbidity and mortality.
Going forward, due to the shortage of physicians currently trained to treat hepatitis C, HIV providers will have to be the treaters for their coinfected patients and treat not just their HIV but also their Hepatitis C infection.