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 acc...

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Main Authors: Mark Hull, Stephen Shafran, Alex Wong, Alice Tseng, Pierre Giguère, Lisa Barrett, Shariq Haider, Brian Conway, Marina Klein, Curtis Cooper
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Canadian Journal of Infectious Diseases and Medical Microbiology
Online Access:http://dx.doi.org/10.1155/2016/4385643
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author Mark Hull
Stephen Shafran
Alex Wong
Alice Tseng
Pierre Giguère
Lisa Barrett
Shariq Haider
Brian Conway
Marina Klein
Curtis Cooper
author_facet Mark Hull
Stephen Shafran
Alex Wong
Alice Tseng
Pierre Giguère
Lisa Barrett
Shariq Haider
Brian Conway
Marina Klein
Curtis Cooper
author_sort Mark Hull
collection DOAJ
description 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.
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publishDate 2016-01-01
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series Canadian Journal of Infectious Diseases and Medical Microbiology
spelling doaj-art-9cf75a5f19c7423d9501c435315d16d02025-08-20T02:20:17ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95321918-14932016-01-01201610.1155/2016/43856434385643CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and TreatmentMark Hull0Stephen Shafran1Alex Wong2Alice Tseng3Pierre Giguère4Lisa Barrett5Shariq Haider6Brian Conway7Marina Klein8Curtis Cooper9British Columbia Centre for Excellence in HIV/AIDS, University of British Columbia, Vancouver, BC, V6T 1Z4, CanadaUniversity of Alberta, Edmonton, AB, T6G 2R3, CanadaRegina Qu’Appelle Health Region, Regina, SK, S4P 1E2, CanadaToronto General Hospital, Toronto, ON, M5G 2C4, CanadaThe Ottawa Hospital, Ottawa, ON, K1H 8L6, CanadaDalhousie University, Halifax, NS, B3H 4R2, CanadaMcMaster University, Hamilton, ON, L8S 4L8, CanadaVancouver Infectious Diseases Centre, Vancouver, BC, V6Z 2C7, CanadaMcGill University, Montreal, QC, H3A 0G4, CanadaThe Ottawa Hospital, General Campus, G12, 501 Smyth Road, Ottawa, ON, K1H 8L6, CanadaBackground. 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.http://dx.doi.org/10.1155/2016/4385643
spellingShingle Mark Hull
Stephen Shafran
Alex Wong
Alice Tseng
Pierre Giguère
Lisa Barrett
Shariq Haider
Brian Conway
Marina Klein
Curtis Cooper
CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
Canadian Journal of Infectious Diseases and Medical Microbiology
title CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
title_full CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
title_fullStr CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
title_full_unstemmed CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
title_short CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment
title_sort cihr canadian hiv trials network coinfection and concurrent diseases core research group 2016 updated canadian hiv hepatitis c adult guidelines for management and treatment
url http://dx.doi.org/10.1155/2016/4385643
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