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CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
Background. Hepatitis C virus (HCV) coinfection occurs in 20–30% of Canadians living with HIV and is responsible for a heavy burden of morbidity and mortality. Purpose. To update national standards for management of HCV-HIV coinfected adults in the Canadian context with evolving evidence for and accessibility of effective and tolerable DAA therapies. The document addresses patient workup and treatment preparation, antiviral recommendations overall and in specific populations, and drug-drug interactions. Methods. A standing working group with HIV-HCV expertise was convened by The Canadian Institute of Health Research HIV Trials Network to review recently published HCV antiviral data and update Canadian HIV-HCV Coinfection Guidelines. Results. The gap in sustained virologic response between HCV monoinfection and HIV-HCV coinfection has been eliminated with newer HCV antiviral regimens. All coinfected individuals should be assessed for interferon-free, Direct Acting Antiviral HCV therapy. Regimens vary in content, duration, and success based largely on genotype. Reimbursement restrictions forcing the use of pegylated interferon is not acceptable if optimal patient care is to be provided. Discussion. Recommendations may not supersede individual clinical judgement. Treatment advances published since December 2015 are not considered in this document.
- Toronto General Hospital Canada
- University Health Network Canada
- University of British Columbia Canada
Medical Subject Headings: virus diseases
Article Subject
Article Subject
Medical Subject Headings: virus diseases
271128
Nakagawa, F., Lodwick, R. K., Smith, C. J., Smith, R., Cambiano, V., Lundgren, J. D., Delpech, V., Phillips, A. N.. Projected life expectancy of people with HIV according to timing of diagnosis. AIDS. 2012; 26 (3): 335-343
Samji, H., Cescon, A., Hogg, R. S., Modur, S. P., Althoff, K. N., Buchacz, K., Burchell, A. N., Cohen, M., Gebo, K. A., Gill, M. J., Justice, A., Kirk, G., Klein, M. B., Korthuis, P. T., Martin, J., Napravnik, S., Rourke, S. B., Sterling, T. R., Silverberg, M. J., Deeks, S., Jacobson, L. P., Bosch, R. J., Kitahata, M. M., Goedert, J. J., Moore, R., Gange, S. J.. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS ONE. 2013; 8 (12) [OpenAIRE]
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Klein, M. B., Rollet, K. C., Saeed, S., Cox, J., Potter, M., Cohen, J., Conway, B., Cooper, C., Côté, P., Gill, J., Haase, D., Haider, S., Harris, M., Hull, M., Moodie, E., Montaner, J., Pick, N., Rachlis, A., Rouleau, D., Wong, D., Sandre, R., Tyndall, M., Walmsley, S.. HIV and hepatitis C virus coinfection in Canada: challenges and opportunities for reducing preventable morbidity and mortality. HIV Medicine. 2013; 14 (1): 10-20
Weber, R., Sabin, C. A., Friis-Moller, N.. Liver-related deaths in persons infected with the human immunodeficiency virus the D:A:D study. Archives of Internal Medicine. 2006; 166 (15): 1632-1641
Coffin, C. S., Fung, S. K., Ma, M. M.. Management of chronic hepatitis B: Canadian Association for the Study of the Liver consensus guidelines. Canadian Journal of Gastroenterology. 2012; 26 (12): 917-938
Myers, R. P., Ramji, A., Bilodeau, M., Wong, S., Feld, J. J.. An update on the management of hepatitis C: consensus guidelines from the Canadian Association for the Study of the Liver. Canadian Journal of Gastroenterology. 2012; 26 (6): 359-375
Lima, V. D., Hogg, R. S., Harrigan, P. R., Moore, D., Yip, B., Wood, E., Montaner, J. S. G.. Continued improvement in survival among HIV-infected individuals with newer forms of highly active antiretroviral therapy. AIDS. 2007; 21 (6): 685-692
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Thomas, D. L.. The challenge of hepatitis C in the HIV-infected person. Annual Review of Medicine. 2008; 59: 473-485
- Toronto General Hospital Canada
- University Health Network Canada
- University of British Columbia Canada
Background. Hepatitis C virus (HCV) coinfection occurs in 20–30% of Canadians living with HIV and is responsible for a heavy burden of morbidity and mortality. Purpose. To update national standards for management of HCV-HIV coinfected adults in the Canadian context with evolving evidence for and accessibility of effective and tolerable DAA therapies. The document addresses patient workup and treatment preparation, antiviral recommendations overall and in specific populations, and drug-drug interactions. Methods. A standing working group with HIV-HCV expertise was convened by The Canadian Institute of Health Research HIV Trials Network to review recently published HCV antiviral data and update Canadian HIV-HCV Coinfection Guidelines. Results. The gap in sustained virologic response between HCV monoinfection and HIV-HCV coinfection has been eliminated with newer HCV antiviral regimens. All coinfected individuals should be assessed for interferon-free, Direct Acting Antiviral HCV therapy. Regimens vary in content, duration, and success based largely on genotype. Reimbursement restrictions forcing the use of pegylated interferon is not acceptable if optimal patient care is to be provided. Discussion. Recommendations may not supersede individual clinical judgement. Treatment advances published since December 2015 are not considered in this document.