Hepatitis C and HIV co-infection: new drugs in practice and in the pipeline.

HCV/HIV coinfection continues to represent a serious health issue with risk of liver disease progression and development of hepatocellular carcinoma. Pegylated interferon with ribavirin is approved for treatment but results are suboptimal and tolerability poor. First-generation HCV protease inhibitors appear to significantly improve HCV treatment response in the setting of HIV infection. Interactions with HIV protease inhibitors have been documented, but the significance of this in terms of adverse reactions and HCV or HIV viral breakthrough remains uncertain. Next generation agents hold the promise of even better efficacy, with improved dosing schedules and perhaps decreased risk of drug:drug interactions.