New Options for HCV Treatment: Is Better Good Enough?

An HIV/HCV-coinfected patient who had only a partial response and treatment-limiting adverse effects with prior peginterferon/ribavirin therapy is interested in the new HCV treatment options. Would you recommend them?

A 62-year-old man with HIV/hepatitis C virus (HCV) genotype 1b coinfection and a remote history of injection-drug use is seen for follow-up to discuss the new treatment options for HCV. He has been on HIV treatment since 1998 and is currently stable on tenofovir/FTC + lopinavir/ritonavir, with a CD4 count of 550 cells/mm³ and an undetectable HIV viral load. He has severe lipoatrophy, presumably as a result of prior treatment with d4T + 3TC, which was given initially as dual therapy and then in combination with indinavir.

He underwent a liver biopsy in 2004 that demonstrated mild portal fibrosis, with few septa and no bridging (Metavir score F2). In 2008, he received peginterferon/ribavirin with appropriate weight-based dosing; at baseline, t…

New Options for HCV Treatment: Is Better Good Enough?

Topics