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.

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 / O. Armignacco, M. Andreoni, E. Sagnelli, M. Puoti, R. Bruno, G.B. Gaeta, C.F. Perno, T.A. Santantonio, P. Bonfanti, S. Bonora, M. Borderi, A. Castagna, A. d'Arminio Monforte, A. De Luca, P. Grossi, G. Guaraldi, F. Maggiolo, C. Mussini, C. Sagnelli, M. Tavio, C. Torti, C. Uberti-Foppa, M. Andreoni, G. Angarano, A. Antinori, O. Armignacco, G. Carosi, A. Chirianni, G. Di Perri, M. Galli, A. Lazzarin, G. Rizzardini, E. Sagnelli, G. Taliani. - In: NEW MICROBIOLOGICA. - ISSN 1121-7138. - 37:4(2014 Oct), pp. 423-438.

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

C. F. Perno;P. Bonfanti;A. d'Arminio Monforte;M. Galli;
2014-10

Abstract

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.
antiviral agents; coinfection; HIV infections; HIV-1; hepacivirus; hepatitis C, chronic; humans; Italy; medication reconciliation; practice guidelines as topic; protease inhibitors; treatment outcome
Settore MED/17 - Malattie Infettive
NEW MICROBIOLOGICA
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/355728
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