Managing chronic hepatitis C in HIV-infected patients

Chronic hepatitis C has become a leading cause of morbidity and mortality among HIV-infected persons. All HIV-infected patients should be tested for chronic hepatitis C, and those who are being considered for treatment should undergo genotype assay and quantitative hepatitis C virus (HCV) RNA testing. The HCV genotype is an important predictor of response to therapy and can assist in the treatment decision; the quantitative HCV RNA level is most useful in monitoring response to therapy The introduction of pegylated interferon (PEG-IFN) alfa. represents an important advance in the treatment of hepatitis C. PEG-IFN is administered weekly by subcutaneous injection; the recommended regimen also includes oral ribavirin, 800 to 1200 mg daily in 2 divided doses. Many specialists recommend treating all HCV-HIV-coinfected patients for a minimum of 48 weeks.