Human immunodeficiency virus (HIV) is an infection that has existed within the human race for decades, with no known cure identified to date. The virus kills immune system cells, reducing the body’s ability to fight other severe infections such as tuberculosis and pneumonia, leading to its total damage when already weakened (Bichoupan & Dieterich, 2014). Moreover, people with this virus often have an increased risk of attack from other diseases. Additionally, it usually exists simultaneously with illnesses such as Hepatitis C, which make them comorbid to each other. The comorbidities and their relation to HIV are a rising cause for concern. This paper analyses this relationship, particularly between HIV and Hepatitis C, and the strides made in the medical field to ensure individuals can manage both viruses simultaneously.
With the introduction of highly active antiretroviral therapy (HAART), HIV has growingly become manageable through lifelong treatment. However, liver disease has now become the leading cause of mortality and morbidity in these patients (Bichoupan & Dieterich, 2014). Hepatitis C is in this category, and it often results in severe damage to the liver. This is primarily in the form of inflammation, resulting in fibrosis or scarring (Bichoupan & Dieterich, 2014). Nonetheless, its symptoms can be spread throughout the body resulting in general body vulnerability.
Moreover, it can significantly hinder the liver’s production of bile which inhibits fatty food digestion. This may cause abdominal pain from bile buildup in the stomach (Bichoupan & Dieterich, 2014). The infection is caused by the hepatitis C virus that spreads majorly through an infected person’s body fluids or blood. Empirical evidence asserts that about 30% of individuals with HIV are co-infected with this hepatitis C virus (Bichoupan & Dieterich, 2014). As such, it is a comorbidity of great concern as its effects supersede those of HIV.
This particular comorbidity’s interest was driven by personal experience over the past two decades as an HIV nurse. Its treatment is of interest given scientific advancements made, and it provides hope to HIV-infected patients. Initially, the hepatitis C virus was treated with ribavirin and pegylated interferon, which only allowed about 30% of those co-infected with HIV to achieve sustained virologic response (SVR) (Bichoupan & Dieterich, 2014). Moreover, treatment was in most cases discontinued due to the adversities that patients experienced due to drug-drug interactions with antiretroviral therapies or even resistance. Therefore, most individuals infected would manage HIV, but the hepatitis virus would lead to their deaths.
However, direct-acting antiviral (DAA) tablets are arguably the most effective and safest treatment for individuals today. They include combinations of “sofosbuvir”, “telaprevir”, “simeprevir”, “boceprevir”, and “velpatasvir” (Bichoupan & Dieterich, 2014, p. 954). Still, treatment effectiveness is dependent on the host and viral factors, which is why it is essential to tailor treatment or specific patient needs. These tablets have led to a decreased gap between mono- and co-infected patients and sustained virologic response rates. Even though more studies are still needed to identify shorter therapy combinations, this is a step in the right direction for this comorbidity.
Technological advancements and intensive research have ensured patients co-infected with HIV and hepatitis C have an increased chance of survival. Fighting two or more diseases simultaneously is arguably the most challenging medical situation an individual can face. Nonetheless, direct-acting antiviral tablets allow these individuals to build their immunity as they take the antiviral drugs. Therefore, it is crucial to identify these comorbidities to ensure treatment is tailored to meet the desired needs.
Bichoupan, K., & Dieterich, D. (2014). Hepatitis C in HIV-infected patients: Impact of direct-acting antivirals. Drugs, 74(9), 951-961.