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Editorial
July 10, 2002

Does Hepatitis C Virus Infection Increase the Risk of HIV Disease Progression?

Author Affiliations

Author Affilations: Medical Service, Department of Veterans Affairs Medical Center, and the University of California, San Francisco.

JAMA. 2002;288(2):241-243. doi:10.1001/jama.288.2.241

Liver disease is an increasingly common cause of death in patients with human immunodeficiency virus (HIV) infection.1 Acquisition of hepatitis C virus (HCV) requires blood contact through contaminated needles or by transfusion; sexual transmission of HCV is uncommon.2,3 HIV accelerates the progression of HCV-related liver disease4; thus, exploring HCV treatment in coinfected patients with HCV/HIV is a priority. To date, experience with combination therapies using interferon plus ribavirin in coinfected patients has been limited, and there are emerging concerns about interactions between those drugs and HIV therapies, particularly the interaction between ribavirin and zidovudine and between ribavirin and didanosine.5 Recent data reveal a more rapid progression to cirrhosis in individuals with HCV/HIV coinfection who have not received protease inhibitor therapy, who have consumed excess alcohol, and who have a low CD4 cell count.6 These observations suggest that effective HIV therapy may decrease the progression to advanced HCV-related liver disease.

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