Management of hepatitis C virus and human immunodeficiency virus coinfection.

With the success of highly active antiretroviral therapy in treating HIV, liver disease has emerged as a major cause of morbidity and mortality amongst HCV and HIV coinfected patients. Until recently, the treatment of HCV in HIV positive patients with interferon based regimens and/or first generation directly acting antiviral agents (DAAs) yielded lower sustained virological response (SVR) rates compared to HCV monoinfected patients and treatment was limited by significant side effects and drug-drug interactions. The introduction of second generation DAAs has led to a remarkable improvement in treatment outcomes of HCV/HIV coinfected patients with >90% achieving a SVR with relatively simple and short treatment courses and with minimal adverse effects. In this article, we provide a comprehensive overview of the epidemiology, diagnosis, approach to screening, and treatment of HIV/HCV coinfected patients. We focus particularly on the use of DAAs in this historically difficult to treat HCV-positive patient population.