Antiretroviral Therapy in Chronic Liver Disease: Focus on HIV/HCV Coinfection – Statements of the First Italian Consensus Workshop
Giampiero Carosi 1, Massimo Puoti 1, Giovanni Antonucci 1, Andrea de Luca , Renato Maserati , Carlo Torti 1, Paolo Bonfanti 1, Stefano Bonora 1, Raffaele Bruno 1, Giovanni Battista Gaeta 1, Andrea Antinori 1, Antonella dArminio Monforte 1, Anna Orani 1, Evangelista Sagnelli 1, Antonietta Cargnel 1, Roberto Cauda 1, Francesco Mazzotta 1, Giuseppe Pastore 1, Fredy Suter 1, Vincenzo Vullo 1, Italian ART and the HCV-HIV Coinfection Working Group 1
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*Correspondence: Andrea Antinori, Email not available
Abstract
Hepatitis C virus (HCV) and HIV share common transmission routes and HCV coinfection is frequentin persons living with HIV. Liver enzyme elevation following the initiation of antiretroviral therapyis frequently seen in HIV-infected patients with chronic liver disease, particularly those with chronichepatitis C. This complication may lead to treatment discontinuation, complicating HIV therapeuticmanagement. Multiple factors influence the risk of liver toxicity under antiretroviral therapy, includingthe specific drug in use (e.g. use of full doses of ritonavir), and environmental factors (e.g.alcohol abuse). However a beneficial effect of antiretroviral therapy on liver disease has been supportedby some studies. Despite increasing knowledge of HCV/HIV coinfection, there is no clearconsensus on how to treat HIV in HCV-coinfected patients An Italian group of experts were invitedto discuss in detail the current risks and implications of antiretroviral treatment in HIV-infectedpersons with chronic hepatitis C, and their main conclusions are summarized in this consensusdocument.
