Although HIV/HCV co-infected individuals were historically considered a “difficult to
treat” population in the era of Interferon (IFN)-based anti-HCV treatment, the introduction of directacting
antivirals, characterized by excellent efficacy and good safety profile, has widely revolutionized
the HCV treatment scenario.
Recent real life studies reported excellent sustained virological response rates in HIV/HCV coinfected
subjects, thus confirming data obtained in randomized clinical trials. However, certain issues
have recently emerged in this population. In fact, high rates of acute HCV infection and reinfections
were documented in several studies, particularly in HIV-positive men who have sex with
men. Moreover, drug-drug interactions with ART or other co-medications may require careful considerations
as well as the management of HIV/HCV co-infected subjects with chronic kidney disease
and advanced liver disease in the course of a DAA-based treatment.
Hence, we aim to review DAA efficacy studies performed in HIV/HCV co-infected patients in both
randomized clinical trials and real-world cohorts. In addition, current challenges and future perspectives
are discussed in order to optimize management strategies for HIV/HCV co-infected subjects
and their access to care in clinical practice.