Management Guidelines for the HCV/HIV Co- Infected Adult
Recommendations of a Multidisciplinary Expert Panel

PDF Version (130 KB)

Final Version October 31, 2000

Table of Contents

Group Members

Executive Summary
- PDF Version (16 KB)

Introduction

• Epidemiology, Natural History and Treatment of HIV
• Epidemiology, Natural History and Treatment of Hepatitis C
• Impact of Coinfection with HIV and HCV
• Special Issues for the Management of the Patient with Co-infection
• Identification of the Coinfected Patient (see algorithm)

Comprehensive Management of the Co-infected Patient

I.a Address substance use issues

I.b Address Alcohol Use

II.a Assess patient for other hepatic viral infections [35,67]

III Develop an HCV Plan (see algorithm)

• Monitoring HCV Therapy
• Side effects of "combination" therapy and what should be monitored.
• Overall efficacy of interferon and ribavirin therapy in chronic hepatitis C

IV HIV Plan

• Should Treatment of HIV infection precede, follow or be concurrent with therapy for HCV?
• What are the preferred antiretroviral agents for the co-infected patient?
• Should patients with co-infection be monitored more frequently?
• Should Nucleoside Reverse Transcriptase Inhibitors be Discontinued when Ribavirin is used?
• Should certain antiretroviral agents be avoided during concurrent therapy of HCV?
• The Setting for Management of the Co-infected Patient
• Resource/Funding Issues
• Research Priorities
• Figure 1 - Categories for Quality of Evidence
• Table 2: Categories of strength of recommendations

References