Article Commentary: How Important is HIV Therapy for Preventing Liver Fibrosis Progression in HIV–HCV-Coinfected Individuals?

Early HIV therapy in HIV–HCV-coinfected individuals appears advisable in order to not only improve HIV outcome but also delay the natural course of liver disease. Indeed, antiretroviral-therapy-induced control of HIV infection with undetectable plasma HIV RNA levels affects HIV–HCV viral interactions and decreases liver inflammation resulting in lower fibrosis progression rates. Although these findings have influenced current revised HIV guidelines, HIV therapy is still started too late in most HCV-coinfected individuals, suggesting that, particularly in special at-risk patient populations, such as intravenous drug users, barriers to treatment uptake are still existing.