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Background: Treatment eligibility rates in patients with HCV monoinfection have not been directly compared with patients with HCV/HIV coinfection. These data are important for planning interventions to optimize HCV management. Method: We enrolled consecutive HCV-monoinfected and HCV/HIV-coinfected subjects presenting to hepatology and HIV clinics at three academic medical centers. Data were obtained through structured subject and provider interviews and a review of medical records. Results: Of the 399 subjects enrolled, 241 (60%) were HCV monoinfected and 158 (40%) were HCV/HIV coinfected. HCV/HIV-coinfected subjects were less likely to have indications for treatment based on HCV RNA positivity (70.9% vs. 81.3%, p = .04) but were more likely to have at least one contraindication to treatment (81.6% vs. 64.9%, p Conclusions: HCV/HIV-coinfected persons are less likely to undergo a liver biopsy or be eligible for HCV therapy and are more likely to have treatment contraindications compared with HCV-monoinfected subjects. Strategies to address modifiable factors (e.g., depression, substance abuse) may enhance treatment eligibility in HCV-infected populations. [ABSTRACT FROM AUTHOR]

Background: Initiating antiretroviral therapy in the early stages of HIV infection may afford benefits over delaying treatment. We evaluated the long-term efficacy and tolerrability of indinavir, zidovudine, and lamivudine begun in asymptomatic treatment-naïve adults with baseline CD4 counts ⩾500 cells/mm3 and HIV (v)RNA levels >1000 copies/mL in an open-label, noncomparative study. Method: Proportions of participants with suppressed viremia were assessed using observed data, a model derived from generalized estimating equations counting only treatment-related discontinuations as failures (TRD=F), and a strict intention-to-treat analysis counting all noncompleters as failures (NC=F). Results: 199 participants (median age 34; 79% men; 61% White) with a median CD4 count of 574 (range 130–1204) cells/mm3 and vRNA level of 3.89 (range 2.30–6.50) log10 copies/mL were followed up to 319 weeks. Overall, 142 participants (71%) discontinued the study after a median time of 112 weeks, including 4 (2%) due to unsuppressed viremia and 40 (20%) due to adverse events. After 156 weeks, 98%, 76%, and 53% of participants achieved <400 vRNA copies/mL based on observed data, TRD=F, and NC=F analyses, respectively; corresponding percentages <50 copies/mL were 93%, 72%, and 51%. Mean CD4 count increased by >250 cells/mm3 from baseline. Nausea (69%), fatigue (49%), diarrhea (37%), headache (28%), abdominal pain (28%), hematuria (27%), flank pain (26%), and hyperbilirubinemia (25%) were the most common drug-related adverse events. Conclusion: A minority of participants in this study completed follow-up. Despite durable HIV suppression in most participants remaining on treatment, treatment fatigue may interfere with long-term therapy in asymptomatic HIV-infected patients. [ABSTRACT FROM AUTHOR]