Hepatitis C and HIV infection: biological, clinical, and therapeutic implications.

As deaths from AIDS continue to decline in HIV-infected persons, liver disease is becoming an increasing cause of hospital admission and death in HIV-HCV co-infected persons. The problem is particularly relevant among intravenous drug users and haemophiliacs, most of whom are co-infected. Moreover, the risk of hepatotoxicity is higher with anti-HIV drugs among patients with chronic hepatitis C. Treatment with alpha-interferon provides a similar rate of response in non-severely immunosuppressed HIV-positive subjects as in HIV-negatives, and preliminary results from trials using the combination of interferon plus ribavirin in HIV-HCV co-infection look very promising for both rates of sustained response and safety.