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VIDEO: Treatment of patients with HIV, HCV requires planning, monitoring
There are several principles to keep in mind when choosing treatment regimens for patients coinfected with HIV and hepatitis C virus, according to Carlos Malvestutto, MD, MPH, assistant clinical professor in the division of infectious diseases at The Ohio State University and medical director of the Family AIDS Clinic and Education Services at Nationwide Children’s Hospital.
It is “very important” to ensure that HIV is well-controlled before starting treatment for HCV. This requires addressing barriers to medication adherence and confirming that patients have achieved virologic suppression, according to Malvestutto.
In addition, the direct-acting antivirals used to treat HCV “have many interactions with other drugs,” according to Malvestutto. He reviews different agents that may lead to drug-drug interactions, including tenofovir, which is “usually used as part of the backbone of treatment for HIV.”
In coinfected patients receiving tenofovir, “it is important to monitor urinary parameters and renal function … frequently throughout the treatment for hepatitis C,” Malvestutto said.