European journal of medical research
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Randomized Controlled Trial Clinical Trial
Therapy of special HIV-associated diseases: HCV-HIV-co-infection and AIDS-related Kaposi's sarcoma - official satellite to the 7th European Conference on Clinical Aspects and Treatment of HIV-infection, October 23, 1999 in Lisbon, Portugal.
In the era of highly active antiretroviral therapy (HAART), certain complications of HIV-disease as e.g. opportunistic infections and Kaposi s sarcoma (KS) have significantly diminished. New insights in pathological pathways revealed the role of co-viruses as HHV-8 and HCV so that in our days AIDS-associated KS and chronical hepatitis C (CHC) in HIV-infected persons can be considered as the result of opportunistic infections with HHV-8 or HCV respectively. - Though the overall incidence of AIDS-KS is declining, it remains as a reason of severe disease complication and fatal outcome. Actual therapeutic strategies have to be evaluated regarding safety and efficacy as a major option, while cost-effectiveness of treatment and quality of life aspects for the patient must also be included to assess a successful disease management within the up to now merely palliative setting. HIV-infection evidently triggers the natural course of CHC in terms of more progressive liver disease. Otherwise there seems to be no clinical benefit of HAART on CHC. Until recently IFN-alfa treatment was the only therapy available for patients with CHC. As initial therapy with a combination of IFN-alfa and ribavirin turned out to be more effective than IFN-monotherapy in HCV-infected persons, it has now to be considered to include anti-HCV-combination treatment into the therapeutic program of HIV-HCV-coinfected patients under HAART. - Within the 7th European Conference on Clinical Aspects and Treatment of HIV-Infection, which took place in Lisbon from October 23 to 27 1999, a satellite symposium was organized to evaluate actual treatment options in the management of special HIV-associated complications focussing on AIDS-KS and HCV-HIV-coinfection. ⋯ As the combination therapy of IFN-alfa-2b with ribavirin is the first treatment in CHC, there is an urgent need to consider the therapeutical strategies in this field in HCH-HIV coinfected patients. (ABSTRACT TRUNCATED)