Abstract

HCV-HIV coinfected patients exhibit rapid progression of liver damage relative to HCV monoinfected patients. The availability of new directly acting antiviral agents has dramatically improved outcomes for coinfected patients as sustained virologic response rates now exceed 95% and fibrosis-related parameters are improved. Nevertheless, coinfected patients still have a higher mortality risk and more severe hepatocellular carcinoma compared to HCV monoinfected patients, implying the existence of pathways unique to people living with HIV that continue to promote accelerated liver disease. In this article, we review the pathobiology of liver disease in HCV-HIV coinfected patients in the directly acting antiviral era and explore the mechanisms through which HIV itself induces liver damage. Since liver disease is one of the leading causes of non-AIDS-related mortality in HIV-positive patients, enhancing our understanding of HIV-associated fibrotic pathways will remain important for new diagnostic and therapeutic strategies to slow or reverse liver disease progression, even after HCV cure.

中文翻译：

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深入了解 HCV/HIV 中肝病的病理生理学：它是否会随着 HCV 治愈而结束？

摘要

相对于 HCV 单一感染患者，HCV-HIV 共感染患者表现出肝损伤的快速进展。新的直接作用抗病毒药物的可用性显着改善了合并感染患者的结果，因为持续病毒学反应率现在超过 95%，纤维化相关参数得到改善。尽管如此，与单纯感染 HCV 的患者相比，合并感染的患者仍然具有更高的死亡风险和更严重的肝细胞癌，这意味着存在 HIV 感染者特有的途径，这些途径继续促进加速肝病。在本文中，我们回顾了直接抗病毒时代 HCV-HIV 合并感染患者的肝病病理学，并探讨了 HIV 本身诱导肝损伤的机制。