Prioritization of New Oral Hepatitis C Therapies for HIV Patients
Pablo Barreiro 1, José V. Fernández-Montero 2, Vicente Soriano 3
1 Department of Infectious Diseases, Hospital Carlos III-La Paz University Hospital. Madrid, Spain; 2 Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain; 3 UNIR Health Sciences School and Medical Center, Universidad Internacional de La Rioja, Madrid, Spain
*Correspondence: José V. Fernández-Montero, Email not available
Abstract
Access to antiretroviral therapy prevents progression of immunodeficiency and development of opportunistic cancers and infections in HIV-infected persons. However, the virus cannot be eliminated and lifelong HIV treatment is needed. For this reason, tolerance and side effects have become an important consideration when choosing HIV drugs. Integrase inhibitors (i.e. dolutegravir) and nonnucleoside analogues (i.e. rilpivirine) are the preferred third agents to be used along with a nucleos(t)ide analogue backbone, either abacavir/lamivudine or tenofovir/emtricitabine. Single-tablet regimens with three agents are currently available and significantly improve HIV treatment adherence. In contrast, HIV protease inhibitors are now preferred only for treatment failures, given their greater resistance barrier but increased potential for drug interactions and metabolic complications, including dyslipidemia, insulin resistance and overall higher cardiovascular risk.
