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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2016, Article ID 4385643, 34 pages
http://dx.doi.org/10.1155/2016/4385643
Special Article

CIHR Canadian HIV Trials Network Coinfection and Concurrent Diseases Core Research Group: 2016 Updated Canadian HIV/Hepatitis C Adult Guidelines for Management and Treatment

1British Columbia Centre for Excellence in HIV/AIDS, University of British Columbia, Vancouver, BC, Canada V6T 1Z4
2University of Alberta, Edmonton, AB, Canada T6G 2R3
3Regina Qu’Appelle Health Region, Regina, SK, Canada S4P 1E2
4Toronto General Hospital, Toronto, ON, Canada M5G 2C4
5The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
6Dalhousie University, Halifax, NS, Canada B3H 4R2
7McMaster University, Hamilton, ON, Canada L8S 4L8
8Vancouver Infectious Diseases Centre, Vancouver, BC, Canada V6Z 2C7
9McGill University, Montreal, QC, Canada H3A 0G4
10The Ottawa Hospital, General Campus, G12, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6

Received 25 September 2015; Accepted 15 December 2015

Copyright © 2016 Mark Hull et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.