Herpes virus Reactivation after Initiation of Interferon-Free Antiviral Agents in HIV–HCV-Coinfected Subjects: A New Immune Restoration Disease?

We report four HCV–HIV-coinfected patients who developed herpes zoster or muco-cutaneous herpes virus disease shortly after starting interferon-free antiviral treatment for HCV. We suggest that in our patients the prompt clearance of HCV following direct-acting antivirals leads to a paradoxical effect on the innate and adaptive immune system mediating the reactivation of herpetic infection.