Recommendations for the use of hepatitis C virus protease inhibitors for the treatment of chronic hepatitis C in HIV-infected persons. A position paper of the Italian Association for the Study of Infectious and Tropical Disease
Armignacco, O.; Andreoni, M.; Sagnelli, E.; Puoti, M.; Bruno, R.; Gaeta, G.Battista.; Perno, C.F.; Santantonio, T.A.; Bonfanti, P.; Bonora, S.; Borderi, M.; Castagna, A.; d'Arminio Monforte, A.; De Luca, A.; Grossi, P.; Guaraldi, G.; Maggiolo, F.; Mussini, C.; Sagnelli, C.; Tavio, M.; Torti, C.; Uberti-Foppa, C.; Andreoni, M.; Angarano, G.; Antinori, A.; Armignacco, O.; Carosi, G.; Chirianni, A.; Di Perri, G.; Galli, M.; Lazzarin, A.; Rizzardini, G.; Sagnelli, E.; Taliani, G.
new microbiologica 37(4): 423-438
2014
ISSN/ISBN: 1121-7138 PMID: 25387281 Document Number: 678251
The efficacy data obtained with boceprevir and telaprevir for persons with hepatitis C virus (HCV) genotype 1 infection raise the question of whether HCV protease inhibitors should be used in human immunodeficiency virus (HIV)/HCV co-infected persons. The Italian Association for the Study of Infectious and Tropical Diseases has made these recommendations to provide the rationale and practical indications for the use of triple anti-HCV therapy in persons living with HIV (PLWHIV). A Writing Committee of experts indicated by the President of the Association and a Consulting Committee con- tributed to the document. The final draft was submitted to the evaluation of external experts and the text modified according to their suggestions and comments. Treatment of HCV co-infection should be considered for all HCV RNA positive PLWHIV. Response-guided therapy with pegylated interferon and ribavirin is the standard treatment of PLWHIV with infection by HCV genotype 2, 3, 4, 5 and 6. Boceprevir and telaprevir should be used to treat HCV genotype 1 infection in HIV/HCV co-infected patients for 48 weeks on an individual basis, with close monitoring of their efficacy and tolerability with concur- rent antiretroviral therapy, taking into account potential drug-drug interactions. The decision to treat a patient or to wait for better treatment options, or to discontinue treatment should be made on an individual basis taking into account pre-treatment variables and the on-treatment HCV RNA kinetics.