HIV/HCV co-infection: the magnitude of the problem

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) share routes of transmission, therefore their coinfection is relatively common. Nevertheless, the clinical relevance of this event has been minimal until few years ago when, due to the increased survival of HIV-infected individuals (favoured by highly active antiretroviral therapy) morbility and mortality caused by pathologies not strictly related to HIV (such as HCV infection) raised sharply. Despite differences in their general characteristics (including lifecycle, target cells, and type of persistence in the infected host) a remarkable level of interaction exists between HCV and HIV; this makes the progression of both liver disease and immunological damage easier and more rapid. A therapeutic approach to HIV/HCV coinfection thus requires the utilization of drugs and strategies effective against both viruses, yet, timing, drug types, and effective combinations still remain poorly defined. New and innovative studies specifically focused on HIV/HCV coinfection are thus warranted to increase the knowledge about their interaction, and define therapeutic strategies aimed to the best management of the infection by both viruses during coinfection.